Pridjian A K, Pearce F B, Culpepper W S, Williams L C, Van Meter C H, Ochsner J L
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
J Thorac Cardiovasc Surg. 1993 Dec;106(6):1122-5.
Although the atrioventricular valve and its attachments can sometimes obscure the superior margin of a ventricular septal defect, concern for valvular competence has made surgeons hesitant to take down the atrioventricular valve. Over a 10-year period, the right atrioventricular valve was taken down to improve exposure for ventricular septal defect repair in 40 patients at our institution, and follow-up echocardiographic studies to determine the degree of valvular regurgitation were available in 32. On the basis of the area of the color flow jet, valvular regurgitation was graded as none in 22 and trivial in 10. Heart block did not develop in any patient, and there were no deaths. Takedown and resuspension of the atrioventricular valve is a safe and effective technique that improves exposure for ventricular septal defect repair and does not adversely affect valve competence.
尽管房室瓣及其附着结构有时会遮挡室间隔缺损的上缘，但由于担心瓣膜功能不全，外科医生一直对拆除房室瓣犹豫不决。在10年期间，我们机构有40例患者为改善室间隔缺损修复的视野而拆除了右房室瓣，其中32例患者有后续超声心动图研究以确定瓣膜反流程度。根据彩色血流喷射面积，22例患者瓣膜反流分级为无，10例为轻微。所有患者均未发生心脏传导阻滞，也无死亡病例。拆除并重新悬吊房室瓣是一种安全有效的技术，可改善室间隔缺损修复的视野，且不会对瓣膜功能产生不利影响。
