Cabrera A, Irurita M, Lekuona I, Galdeano J M, Chouza M, Mendía M I, Azcárate M J, Arrinda J M, Pastor E
An Esp Pediatr. 1986 Jan;24(1):27-33.
We present the pathological study of 17 cases of mitral atresia with patent aortic valve and their surgical implications. The study is based on the type of atrioventricular connection, presence or absence of ventricular septum, size of the left ventricle and relation of the aorta with the aforementioned ventricle. We have classified mitral atresia into two groups by assessing these data. Group A) Both ventricles and atrioventricular connections are present and there is ventricular septal defect. The aorta may connect with an either normal or hypoplastic left ventricle or it may emerge in double outlet from the right ventricle. Group B) Absent left ventricle and atrioventricular connection. The aorta emerges from the single ventricle or the rudimentary chamber. Thirteen cases belonged to group A and four to group B. The pathological structure of mitral atresia requires the decompression of the left atrium by atrioseptostomy during the neonatal period to enable survival. On a second stage a palliative correction should be carried out, which; depending on ventricular size and outlet of the vessels, will be a valvular prosthesis left atrium-left ventricle or the modified atriopulmonary technique connecting the new left atrium with the systemic ventricle and aorta after resecting the auricular septum and connecting the right atrium with the pulmonary artery.
我们展示了17例伴有主动脉瓣开放的二尖瓣闭锁病例的病理学研究及其手术意义。该研究基于房室连接类型、室间隔的有无、左心室大小以及主动脉与上述心室的关系。通过评估这些数据,我们将二尖瓣闭锁分为两组。A组:两个心室和房室连接均存在且有室间隔缺损。主动脉可与正常或发育不全的左心室相连,也可能从右心室双出口发出。B组:左心室和房室连接缺失。主动脉从单心室或残腔发出。13例属于A组,4例属于B组。二尖瓣闭锁的病理结构要求在新生儿期通过房间隔造口术对左心房进行减压以维持生存。在第二阶段应进行姑息性矫正,这取决于心室大小和血管出口情况,将是植入瓣膜假体的左心房-左心室连接,或改良的心房-肺动脉技术,即在切除心耳间隔并将右心房与肺动脉连接后,将新的左心房与体循环心室和主动脉连接。