Oku H, Kitayama H, Matsumoto T
Department of Cardiovascular Surgery, Kinki University School of Medicine, Osakasayama, Japan.
Kyobu Geka. 1995 Jul;48(8):616-23.
The surgical and postoperative long-term results were assessed in 55 patients undergoing correction of complete atrioventricular septal defects. The patients was divided into two groups according to mode of plasty of the atrioventricular valve: 45 patients in whom the cleft was closed in the earlier series, and 10 with trifoliated mitral valve, leaving the cleft unclosed in the later series. The early death occurred in 13 of 45 patients in the earlier series and none in the later series. During 11 years follow up period, mitral valve regurgitation of grade 3 and 4 was observed in 20% of the patients, respectively, in the earlier series. In contrast, grade 3 mitral regurgitation was detected in only one and no grade 4 regurgitation was present in the later series. Tricuspid valve regurgitation was irrelevant. In the later series, the diameter of the mitral valve was greater than the average value of Rowlatt's standard by 3.4 mm after partisioning the common atrioventricular valve into mitral and tricuspid components, and smaller than the normal by 0.2 mm, though the diameter was within the normal range after valvulo-and annuloplasty. On the other hand, the diameter of the tricuspid valve was also greater than the normal value by 1.7 mm after partisioning, however, that was smaller than the normal by 1.7 mm after valvulo-and annuloplasty, on the average. The diameter was smaller than the normal lower limit by one standard deviation in two patients. There was present neither mitral nor tricuspid stenosis in all on the post-operative hemodynamic study.(ABSTRACT TRUNCATED AT 250 WORDS)
对55例接受完全性房室间隔缺损矫正术的患者的手术及术后长期结果进行了评估。根据房室瓣成形方式将患者分为两组:早期系列中45例患者的瓣裂被闭合,后期系列中有10例三叶形二尖瓣患者,瓣裂未闭合。早期系列中的45例患者中有13例发生早期死亡,后期系列中无早期死亡病例。在11年的随访期内,早期系列中分别有20%的患者出现3级和4级二尖瓣反流。相比之下,后期系列中仅1例检测到3级二尖瓣反流,无4级二尖瓣反流。三尖瓣反流无相关性。在后期系列中,将共同房室瓣分为二尖瓣和三尖瓣组件后,二尖瓣直径比Rowlatt标准平均值大3.4mm,瓣膜和瓣环成形术后比正常小0.2mm,尽管直径仍在正常范围内。另一方面,三尖瓣直径在分隔后也比正常值大1.7mm,但瓣膜和瓣环成形术后平均比正常小1.7mm。两名患者的直径比正常下限小一个标准差。术后血流动力学研究显示,所有患者均无二尖瓣或三尖瓣狭窄。(摘要截断于250字)