Kawashima Y, Fujita T, Mori T, Ihara K, Manabe H
J Thorac Cardiovasc Surg. 1977 Aug;74(2):191-4.
Fourteen patients ranging in age from 4 months to 28 years underwent closure of a ventricular septal defect (VSD) through the pulmonary valve after pulmonary arteriotomy. In 13 of these the VSD was of the supracristal type and in one patient it was of the bulboventricular type. In all patients, including two infants whose VSD was closed under circulatory arrest, the operative and postoperative courses were uneventful except in one, who needed prolonged respiratory care. Right bundle branch block (RBBB) resulted in four patients, one of whom had a bulboventricular defect. The procedure is technically feasible without difficulty when the VSD is of the supracristal type and when the patient is too small. Trans-pulmonary arterial closure is the method of choice for treating a supracristal VSD, as this procedure leaves no postoperative right ventricular scar. However, the advisability of continuing to use this procedure is to be decided after statistical analysis of the frequency of postoperative RBBB can be made with a larger series of patients.
14例年龄从4个月至28岁的患者在肺动脉切开术后经肺动脉瓣闭合室间隔缺损（VSD）。其中13例为嵴上型室间隔缺损，1例为球室型室间隔缺损。所有患者，包括2例在循环停止下闭合室间隔缺损的婴儿，手术及术后过程均顺利，只有1例需要延长呼吸支持。4例患者出现右束支传导阻滞（RBBB），其中1例为球室型缺损。当室间隔缺损为嵴上型且患者年龄过小时，经肺动脉闭合术在技术上可行且无困难。经肺动脉闭合术是治疗嵴上型室间隔缺损的首选方法，因为该手术不会在术后留下右心室瘢痕。然而，在对更多患者系列进行术后右束支传导阻滞发生率的统计分析后，再决定是否继续使用该手术方法。
