Moreno-Cabral R J, Mamiya R T, Nakamura F F, Brainard S C, McNamara J J
J Thorac Cardiovasc Surg. 1977 Mar;73(3):358-65.
Twenty-five patients with ventricular septal defect (VSD) associated with aortic insufficiency (AI) have been since 1964. Of these patients, one died suddenly without operation; in 2 patients, AI developed in the late postoperative period following VSD closure; and in 3 others, AI developed shortly after VSD closure. The remaining 19 patients are discussed in detail. The VSD was subpulmonic in 13 (68 per cent) and subcristal in 6 (32 per cent). Primary suture of the VSD was undertaken in 13 patients and patch closure in 6. Seven patients had aortic valvuloplasty and 2 had aortic valve replacement. There were no surgical deaths, and the long-term follow-up shows that VSD closure alone has been sufficient to arrest progression of AI in patients with mild insufficiency, particularly in those with subpulmonic VSD. Valvuloplasty, when necessary, was more effective when done at an early age.
自1964年以来，共收治25例室间隔缺损（VSD）合并主动脉瓣关闭不全（AI）的患者。其中，1例未经手术突然死亡；2例在VSD闭合后的术后晚期出现AI；另外3例在VSD闭合后不久出现AI。其余19例患者将进行详细讨论。VSD位于肺动脉瓣下者13例（68%），嵴下者6例（32%）。13例行VSD直接缝合，6例行补片修补。7例行主动脉瓣成形术，2例行主动脉瓣置换术。无手术死亡病例，长期随访表明，对于轻度关闭不全的患者，尤其是肺动脉瓣下VSD患者，单纯闭合VSD足以阻止AI进展。必要时，瓣膜成形术在早期进行效果更佳。
