Tanji M, Iwaya F, Igari T, Ono T, Hoshino S
Department of Cardiovascular Surgery, Fukushima Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Feb;42(2):257-61.
We report a 3-year-old girl with left ventricular outflow tract obstruction after repair of ostium primum defect. The girl had closure of an ostium primum defect performed at the age of 1 year. Two years later, she developed left ventricular hypertrophy with systolic ejection murmur. Echocardiography showed discrete stenosis of the left ventricular outflow tract. Cardiac catheterization showed a peak systolic gradient of 63 mmHg across the left ventricular outflow tract. At the reoperation, the fibrous tissue was excised and myectomy was done. After the operation the peak systolic gradient across the left ventricular outflow tract disappeared. Since there is a possibility of occurrence of the left ventricular outflow tract obstruction after repair of atrioventricular septal defect, long term follow up is mandatory.
我们报告了一名3岁女孩,在原发孔缺损修复后出现左心室流出道梗阻。该女孩在1岁时进行了原发孔缺损闭合术。两年后,她出现左心室肥厚并伴有收缩期喷射性杂音。超声心动图显示左心室流出道存在离散性狭窄。心导管检查显示左心室流出道的收缩期峰值压差为63 mmHg。再次手术时,切除了纤维组织并进行了心肌切除术。术后左心室流出道的收缩期峰值压差消失。由于房室间隔缺损修复后有可能发生左心室流出道梗阻,因此必须进行长期随访。