Simpson W F, Sade R M, Crawford F A, Taylor A B, Fyfe D A
Ann Thorac Surg. 1987 Jul;44(1):7-10. doi: 10.1016/s0003-4975(10)62343-0.
Thirty (10.8%) of 279 patients undergoing correction of a ventricular septal defect (VSD) from January, 1972, to September, 1986, also had a double-chambered right ventricle (DCRV). Age at operation ranged from 1.3 to 18.8 years (mean, 6.7 +/- 4.5 years [+/- standard deviation]). Seventeen patients were male, and 13 were female. Two-dimensional echocardiography was used after 1978 in the initial evaluation of 20 patients; however, the diagnosis of DCRV was made with the use of subcostal views only since 1984 in 4 of 5 patients. Surgical correction consisted of closure of the VSD and resection of anomalous muscle bundles through a right ventriculotomy (28 patients), and right atriotomy (2 patients). All patients survived and are asymptomatic 4.2 +/- 3.4 years following operation. Six patients have undergone catheterization postoperatively and 8 patients had intraoperative pressure recordings. The mean preoperative ratio of right ventricular to left ventricular pressures was 0.67 +/- 0.22 compared with 0.34 +/- 0.15 postoperatively (p less than .001). In 2 patients, DCRV was not recognized preoperatively or at VSD closure through a right atriotomy, and reoperation was necessary after DCRV was demonstrated at postoperative catheterization. DCRV may occur in approximately 10% of patients undergoing correction of VSD. Careful evaluation of echocardiographic and catheterization data preoperatively and careful evaluation of the anatomy intraoperatively are necessary so that DCRV not be overlooked, especially because most VSDs are now closed through the right atrium. Successful correction of VSD and DCRV is associated with excellent long-term results.
在1972年1月至1986年9月期间接受室间隔缺损（VSD）矫正手术的279例患者中，有30例（10.8%）同时患有双腔右心室（DCRV）。手术年龄在1.3岁至18.8岁之间（平均6.7±4.5岁[±标准差]）。17例为男性，13例为女性。1978年后，二维超声心动图用于20例患者的初始评估；然而，自1984年起，仅通过肋下视图才对5例患者中的4例做出DCRV诊断。手术矫正包括通过右心室切开术（28例患者）和右心房切开术（2例患者）闭合VSD并切除异常肌束。所有患者术后存活且无症状，随访时间为4.2±3.4年。6例患者术后接受了心导管检查，8例患者术中进行了压力记录。术前右心室与左心室压力的平均比值为0.67±0.22，术后为0.34±0.15（p<0.001）。2例患者术前或通过右心房切开术闭合VSD时未识别出DCRV，术后心导管检查证实有DCRV后需要再次手术。DCRV可能发生在约10%接受VSD矫正的患者中。术前仔细评估超声心动图和心导管检查数据以及术中仔细评估解剖结构是必要的，这样才能不遗漏DCRV，特别是因为现在大多数VSD是通过右心房闭合的。VSD和DCRV的成功矫正与优异的长期结果相关。
