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[1例哈代手术后三尖瓣反流增加的埃布斯坦畸形再次手术病例]

[A case of reoperation of Ebstein's anomaly with increased tricuspid regurgitation after Hardy's operation].

作者信息

Saito F, Sakamoto Y, Kurosawa H

机构信息

Department of Surgery, Saku Central Hospital, Nagano, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1995 Mar;43(3):390-3.

PMID:7769350
Abstract

A 30-year-old man, who had undergone Hardy's operation and the direct closure of an atrial septal defect for Ebstein's anomaly at age 9, was reoperated on by Carpentier's procedure for a long-standing tricuspid regurgitation. He required IABP support to wean from the cardiopulmonary bypass for the acute heart failure. Nonetheless, his postoperative course was uneventful. Echocardiography, nine months after the operation, showed a decrease in moderate residual regurgitation and an increase in the right ventricular inflow velocity, which were considered signs of an improvement in the right ventricular function and, furthermore, it showed an increase in the left ventricular volume and a marked improvement in the left ventricular ejection fraction. We consider that tricuspid regurgitation for many years result in a dysfunction in the right ventricle and, because of a decrease in the filling volume, in the left ventricle. For this reason, we should positively perform an operation without leaving tricuspid regurgitation as it is.

摘要

一名30岁男性,9岁时因埃布斯坦畸形接受了哈代手术及房间隔缺损直接闭合术,现因长期三尖瓣反流接受了卡彭蒂埃手术。他在体外循环脱机时因急性心力衰竭需要主动脉内球囊反搏支持。尽管如此,他的术后过程平稳。术后9个月的超声心动图显示中度残余反流减少,右心室流入速度增加,这些被认为是右心室功能改善的迹象,此外,还显示左心室容积增加,左心室射血分数显著改善。我们认为,多年的三尖瓣反流会导致右心室功能障碍,并且由于充盈量减少,也会导致左心室功能障碍。因此,我们应该积极地进行手术,而不是任由三尖瓣反流存在。

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