Rey C, Vaksmann G, Brevière G M, Francart C, Dupuis C
Service de cardiologie infantile, hôpital Cardiologique, Lille.
Arch Mal Coeur Vaiss. 1991 May;84(5):627-31.
Between 1974 and 1989, eight children undergoing surgical repair of a partial atrioventricular canal comprising an ostium primum atrial septal defect, mitral regurgitation due to a cleft mitral valve (6 cases) and a small ventricular septal defect (1 case) developed aortic regurgitation. This complication was diagnosed on the finding of a diastolic murmur 1 day to 9 years after the repair of the atrial septal defect. The degree of regurgitation was Grade I in 4 cases but in the other patients it was severe from the outset requiring emergency surgery the next day (1 case), or moderate at the beginning but rapidly progressive (1 case) or slowly progressive (2 cases) leading to aortic valvuloplasty in these 3 patients. The cause of the regurgitation was iatrogenic: perforation of the non coronary cusp secondary to repair of the ostium primum atrial septal defect. None of the patients required aortic valve replacement. After surgical valvuloplasty, all children had Grade 1 aortic regurgitation. Color coded Doppler echocardiography confirmed the diagnosis and helped assess the clinical course of this lesion during follow-up.
1974年至1989年间，8名接受部分房室通道手术修复的儿童出现了主动脉瓣反流。该部分房室通道包括原发孔型房间隔缺损、因二尖瓣裂所致的二尖瓣反流（6例）和小型室间隔缺损（1例）。这种并发症是在房间隔缺损修复术后1天至9年发现舒张期杂音时确诊的。反流程度为I级的有4例，而其他患者一开始即为重度反流，其中1例次日即需急诊手术，1例起初为中度反流但进展迅速，2例进展缓慢，这3例患者均接受了主动脉瓣成形术。反流的原因是医源性的：继发于原发孔型房间隔缺损修复术的无冠瓣穿孔。所有患者均无需进行主动脉瓣置换。手术主动脉瓣成形术后，所有儿童的主动脉瓣反流均为I级。彩色编码多普勒超声心动图确诊了该病，并有助于在随访期间评估该病变的临床病程。
