Frigiola Alessandro, Abella Raul F, Giamberti Alessandro
Pediatric Cardiac Surgery Department, Policlinico San Donato, San Donato, Milan, Italy.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2006:161-4. doi: 10.1053/j.pcsu.2006.02.022.
Doubly committed subarterial ventricular septal defect complicated by severe aortic regurgitation caused by a prolapsed aortic cusp still represents a challenging surgical problem. We report on our "two-patch" technique, were the ventricular septal defect is closed through the aortic valve by a patch anchored to another patch through the prolapsed cusp. This second patch is pulled up with the prolapsed cusp and is then fixed to the aortic wall. Since May 1990, 15 patients with a mean age of 12 years underwent repair of this cardiac malformation with the "two-patch" technique. The aortic regurgitation was severe in all patients. All patients survived. In a mean follow-up of 10 years, two patients were successfully reoperated for progression of the aortic regurgitation. All the remaining patients were in NYHA functional class I. In conclusion, the "two-patch" technique is simple, easily reproducible, and can be a valid surgical option for this complex cardiac malformation.
双动脉下室间隔缺损合并脱垂主动脉瓣叶导致的严重主动脉反流仍是一个具有挑战性的外科问题。我们报告我们的“双补片”技术，即通过主动脉瓣，经脱垂瓣叶将补片固定于另一补片来闭合室间隔缺损。将这第二个补片与脱垂瓣叶一并提起，然后固定于主动脉壁。自1990年5月以来，15例平均年龄12岁的患者接受了用“双补片”技术修复这种心脏畸形。所有患者均有严重主动脉反流。所有患者均存活。平均随访10年，2例患者因主动脉反流进展成功接受再次手术。其余所有患者纽约心脏协会（NYHA）心功能分级均为I级。总之，“双补片”技术操作简单、易于重复，对于这种复杂心脏畸形可以作为一种有效的手术选择。
