Bol Raap Goris, Meijboom Folkert J, Kappetein A Pieter, Galema Tjebbe W, Yap Singh-Chien, Bogers Ad J J C
Department of Cardiothoracic Surgery, Thoraxcentre, Erasmus MC University Hospital, Rotterdam, The Netherlands.
Eur J Cardiothorac Surg. 2007 Aug;32(2):215-9. doi: 10.1016/j.ejcts.2007.04.023. Epub 2007 Jun 12.
To study patients who underwent surgical closure of a congenital ventricular septal defect (VSD) and presenting at adult age.
A retrospective study was carried out of 28 patients (15 male) operated upon between 1980 and 2004. Patients were investigated by echocardiography, ECG and assessed for quality of life by a questionnaire. The indication for surgery was volume overload in 11 patients, endocarditis in 8, aortic valve regurgitation in 8 and the combination of a VSD with subvalvular aortic stenosis in 1. Follow-up was complete with a mean duration of follow-up of 13 years. There was no early or late mortality. One patient was reoperated for recurrent VSD. Twenty-five patients underwent echocardiography, which revealed a trivial residual VSD in two and mild aortic regurgitation in 10 (40%) patients. One patient was in atrial fibrillation. Health related quality of life in the dimensions cognitive functioning and sleep differed significantly from that of the general population.
With a relative difference in indications for closure of a VSD in adulthood, surgical closure of VSD at adult age is an adequate and safe procedure, with good results on long-term follow-up. Progression of aortic valve regurgitation is a matter of concern.
研究成年后接受先天性室间隔缺损(VSD)手术闭合的患者。
对1980年至2004年间接受手术的28例患者(15例男性)进行回顾性研究。通过超声心动图、心电图对患者进行检查,并通过问卷调查评估生活质量。手术指征为11例容量负荷过重、8例感染性心内膜炎、8例主动脉瓣反流以及1例VSD合并主动脉瓣下狭窄。随访完整,平均随访时间为13年。无早期或晚期死亡病例。1例患者因复发性VSD再次手术。25例患者接受了超声心动图检查,结果显示2例有轻微残余VSD,10例(40%)患者有轻度主动脉反流。1例患者出现心房颤动。在认知功能和睡眠方面,与健康相关的生活质量与普通人群有显著差异。
成年期VSD闭合的指征存在相对差异,成年后VSD手术闭合是一种适当且安全的手术,长期随访效果良好。主动脉瓣反流的进展是一个值得关注的问题。