Laura J P, Galindez E, Kreutzer G, Neirotti R, Coronel A R
Arch Mal Coeur Vaiss. 1977 Apr;70(4):365-71.
The authors report a series of 11 patients with ventricular septal defect associated with aortic incompetence who underwent surgery between 1963 and March 1976. Separate consideration is given to the operations performed before and after 1972. 5 patients were operated on during the first period, with only mediocre results. At this time, the technique of valvuloplasty did not appear to be the right one. During the second period, 6 patients were operated on. In five of them the technique of Plauth, Frater, Spencer and Trusler was used. All these patients have a satisfactory result. The last of the series had an abnormally low commissure, and the adjacent valves were protuberant, and thickened, so that a valvular replacement was carried out. The operation of choice for a ventricular septal defect associated with aortic incompetence is valvuloplasty with closure of the defect. The following criteria are necessary indications for this type of surgery: --the aortic incompetence must be secondary to the prolapse of a valve; --the aortic valve must have three cusps. An early operation makes the valvuloplasty easier, and avoids the problems of damage to the left ventricle from a persistant and progressive aortic incompetence.
作者报告了1963年至1976年3月期间接受手术的11例室间隔缺损合并主动脉瓣关闭不全的患者。分别考虑了1972年前后进行的手术。第一阶段有5例患者接受了手术，结果仅属一般。此时，瓣膜成形术的技术似乎并不合适。第二阶段有6例患者接受了手术。其中5例采用了普劳特、弗雷特、斯宾塞和特鲁斯勒的技术。所有这些患者都取得了满意的结果。该系列的最后一例患者连合部异常低，相邻瓣膜突出且增厚，因此进行了瓣膜置换。室间隔缺损合并主动脉瓣关闭不全的首选手术是瓣膜成形术并关闭缺损。以下标准是这类手术的必要指征：——主动脉瓣关闭不全必须继发于瓣膜脱垂；——主动脉瓣必须有三个瓣叶。早期手术使瓣膜成形术更容易，并避免了持续性和进行性主动脉瓣关闭不全对左心室造成损害的问题。
