Chiu I S, Chao S F, Wu M H, Wang J K, How S W, Hung C R, Lue H C
Taiwan Yi Xue Hui Za Zhi. 1989 Jul;88(7):718-21.
The choice of a valved conduit or a valve in the right ventricular outflow tract remains a problem. We propose to reconstruct the pulmonary valve inside the patient's own pulmonary trunk by autologous pericardium in tri-semilunar fashion with concomitant formation of the sinus of Valsalva and commissure. This operation was carried out on a 7-year-old girl suffering from Fallot's tetralogy with an absent pulmonary valve. The ventricular septal defect was repaired and the pulmonary valve reconstructed as above. The postoperative cross-sectional echocardiogram, color Doppler echocardiogram and angiogram showed a pliable tri-semilunar valve across the pulmonary outflow tract without regurgitation. It is concluded that firstly, the sinus of Valsalva is indispensable for a stentless semilunar valve to be competent; secondly, reconstruction of the semilunar valve inside the pulmonary trunk by autologous pericardium is recommended for the absent pulmonary valve syndrome, but the long-term fate of this pericardial valve awaits further evaluation.
在右心室流出道选择带瓣管道或瓣膜仍然是个问题。我们建议通过自体心包以三叶半月形方式在患者自身肺动脉干内重建肺动脉瓣，同时形成主动脉窦和瓣叶联合。该手术在一名患有法洛四联症且肺动脉瓣缺如的7岁女孩身上进行。修复了室间隔缺损，并按上述方法重建了肺动脉瓣。术后的横截面超声心动图、彩色多普勒超声心动图和血管造影显示，在肺动脉流出道有一个柔韧的三叶半月形瓣膜，无反流。得出的结论是，首先，主动脉窦对于无支架半月瓣发挥功能是必不可少的；其次，对于肺动脉瓣缺如综合征，建议通过自体心包在肺动脉干内重建半月瓣，但这种心包瓣膜的长期转归有待进一步评估。
