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目的探讨应用自制带单向活瓣补片矫治室间隔缺损合并重度肺动脉高压的方法及疗效。方法采用自体心包片缝制于中央打孔的涤纶补片上形成单向活瓣,用该补片修补15例伴有重度肺动脉高压的室间隔缺损患者,术后早期观察其血流动力学变化。结果术后无早期死亡,6例出现低氧血症需呼吸机支持;术后2周复查心脏彩超,12例活瓣已关闭,3例存在右向左分流;其中1例术后2个月活瓣关闭。结论带单向活瓣补片修补伴重度肺动脉高压的室间隔缺损,术后早期特定情况下活瓣开放,出现右向左分流,可以有效缓解右心室后负荷,使患者能度过术后危险期,减少围手术期病死率。
Objective To explore the method and efficacy of self-made patch with unidirectional flap for correction of ventricular septal defect complicated with severe pulmonary hypertension. Methods A self-pericardium was used to make a one-way flap on the central perforated dacron patch. Fifteen patients with ventricular septal defect with severe pulmonary hypertension were repaired with this patch. The hemodynamic changes were observed early after operation. Results There were no early deaths in 6 cases, hypoxemia in 6 cases required ventilator support; 2 weeks after operation, the color Doppler echocardiography was performed, 12 cases were closed and 3 cases had right-to-left shunt. One case was 2 months after operation The flap is closed. CONCLUSION: Ventricular septal defect with unidirectional flap repair and severe pulmonary hypertension can be used to relieve right ventricular afterload and make patients survive postoperative risk Period, reduce perioperative mortality.