Baird Christopher W, Kreutzer Christian, Sanders Stephen P, Borisuk Michele J, Del Nido Pedro J
Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts.
Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts.
Ann Thorac Surg. 2017 Jul;104(1):e101-e103. doi: 10.1016/j.athoracsur.2017.02.036.
Left atrioventricular (AV) valve regurgitation is the most common complication after a atrioventricular canal defect (AVCD) repair. Despite what appears to be a less complex repair, patients with partial and transitional AV canal have higher reoperation rates for left AV valve regurgitation and left ventricular outflow tract (LVOT) obstruction. Retraction of bridging leaflets with secondary attachments to the septal crest commonly produces increased tension and flattening of the medial left AV valve leaflet and LVOT obstruction after cleft closure. We describe a novel technique of detachment and patch augmentation of bridging leaflets to avoid these complications.
左房室瓣反流是房室管缺损(AVCD)修复术后最常见的并发症。尽管修复过程看似不那么复杂,但部分型和过渡型房室管患者因左房室瓣反流和左心室流出道(LVOT)梗阻而进行再次手术的比例较高。在裂隙闭合后,将带有继发附着于间隔嵴的桥接瓣叶进行牵拉,通常会导致左房室瓣内侧瓣叶张力增加、变平以及LVOT梗阻。我们描述了一种分离和补片增强桥接瓣叶的新技术,以避免这些并发症。