经右心房切口行右心室流出道疏通术_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

何维来 , 周汝元 , 葛圣林 , 张士兵 , 张成鑫 , 冯俊波 , 车轰

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Keywords：

右心室流出道疏通术; 　损伤; 　右心房切口

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目的　总结右心室流出道梗阻经右心房切口、三尖瓣口行右心室流出道疏通术的经验。　方法　自2007年6月至2010年12月，安徽医科大学第一附属医院对21例右室双腔心、单纯右心室流出道狭窄及法洛四联症患者［（14例右室双腔心、4例单纯右心室流出道狭窄和3例法洛四联症，流出道压差为（52.56±17.31） mm Hg］，经右心房切口、三尖瓣口行右心室流出道疏通术，切除异常纤维环和增生肥厚肌束，疏通右心室流出道，对并发肺动脉瓣或瓣下狭窄的患者，再经肺动脉根部切口协助显露，同时矫正其他并发畸形。　结果　所有患者手术顺利，术后心功能均恢复满意，术后超声心动图复查提示：右心室流出道疏通效果满意，压差＜20 mm Hg，7例术后有轻度收缩期杂音。术后随访至6个月，随访期间所有患者体力活动完全恢复；复查心脏彩色超声心动图提示:无明显右心室流出道室壁肥厚增生和再梗阻，右心室流出道压差进一步缩小或消失。　结论　经右心房切口行右心室流出道疏通术适用于右室双腔心、单纯右心室流出道狭窄及部分法洛四联症患者，可避免直接切开右室壁引起的心肌、冠状动脉损伤，减轻了术后瘢痕纤维增生，有利于术后心功能恢复。

Citation： 何维来,周汝元,葛圣林,张士兵,张成鑫,冯俊波,车轰. 经右心房切口行右心室流出道疏通术. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(4): 430-432. doi: Copy

1.	Nakamura T, Gulick J, Colbert MC, et al. Protein tyrosine phosphatase activity in the neural crest is essential for normal heart and skull development. Proc Natl Acad Sci USA, 2009, 106 （27）：11270-11275.
2.	Kreymborg KG, Uchida S, Gellert P, et al. Identification of right heart-enriched genes in a murine model of chronic outflow tract obstruction. J Mol Cell Cardiol, 2010, 49 （4）：598-605.
3.	Wald RM, Haber I, Wald R, et al. Effects of regional dysfunction and late gadolinium enhancement on global right ventricular function and exercise capacity in patients with repaired tetralogy of Fallot. Circulation, 2009, 119 （10）：1370-1377.
4.	Bashore TM. Adult congenital heart disease：right ventricular outflow tract lesions. Circulation, 2007, 115 （14）：1933-1947.
5.	Basu S, Kumar D, Mukherjee D, et al. Double chambered right ventricle and congenital complete heart block：a unique association. Congenit Heart Dis, 2007, 2 （4）：270-274.
6.	Sarikouch S, Schaeffler R, Blanz U, et al. Adult congenital heart disease-double-chambered right ventricle. Clin Res Cardiol, 2007, 96 （8）：582-584.
7.	Starr JP. Tetralogy of fallot：yesterday and today. World J Surg, 2010, 34 （4）：658-668.
8.	Kottayil BP, Dharan BS, Pillai VV, et al. Surgical repair of doubl　e-chambered right ventricle in adulthood. Asian Cardiovasc Thorac Ann, 2011, 19 （1）：57-60.
9.	Tao L, Zeng X. Right ventricular outflow tract patch reconstruction in anomalous origin of right coronary artery. Ann Thorac Surg, 2010, 89 （4）：1314-1316.
10.	Mert M, Cetin G. Right ventricular outflow tract reconstruction for tetralogy of fallot with abnormal coronary artery：experience with 35 patients. J Card Surg, 2006, 21 （2）：131-136.
11.	Yuan SM, Mishaly D, Shinfeld A, et al. Right ventricular outflow tract reconstruction：valved conduit of choice and clinical outcomes. J Cardiovasc Med, 2008, 9 （4）：327-337.
12.	Spiewak M, Biernacka EK, Małek ŁA, et al. Right ventricular outflow tract obstruction as a confounding factor in the assessment of the impact of pulmonary regurgitation on the right ventricular size and function in patients after repair of tetralogy of Fallot. J Magn Reson Imaging, 2011, 33 （5）：1040-1046.
13.	van de Woestijne PC, Mokhles MM, de Jong PL, et al. Right ventricular outflow tract reconstruction with an allograft conduit in patients after tetralogy of Fallot correction：long-term follow-up. Ann Thorac Surg, 2011, 92 （1）：161-166.
14.	Kimberly AH, Dearani JA, Burkhart HM, et al. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg, 2011, 92 （1）：122-130.
15.	Sullivan R, Huang GY, Meyer RA, et al. Heart malformations in transgenic mice exhibiting dominant negative inhibition of gap junctional communication in neural crest cells. Dev Biol, 1998, 204 （1）：224-234.
16.	Butz T, Horstkotte D, Langer C, et al. Significant obstruction of the right and left ventricular outflow tract in a patient with biventricular hypertrophic　cardiomyopathy. Eur J Echocardiogr, 2008, 9 （2）：344-345.

1. 　Nakamura T, Gulick J, Colbert MC, et al. Protein tyrosine phosphatase activity in the neural crest is essential for normal heart and skull development. Proc Natl Acad Sci USA, 2009, 106 （27）：11270-11275.
2. 　Kreymborg KG, Uchida S, Gellert P, et al. Identification of right heart-enriched genes in a murine model of chronic outflow tract obstruction. J Mol Cell Cardiol, 2010, 49 （4）：598-605.
3. 　Wald RM, Haber I, Wald R, et al. Effects of regional dysfunction and late gadolinium enhancement on global right ventricular function and exercise capacity in patients with repaired tetralogy of Fallot. Circulation, 2009, 119 （10）：1370-1377.
4. 　Bashore TM. Adult congenital heart disease：right ventricular outflow tract lesions. Circulation, 2007, 115 （14）：1933-1947.
5. 　Basu S, Kumar D, Mukherjee D, et al. Double chambered right ventricle and congenital complete heart block：a unique association. Congenit Heart Dis, 2007, 2 （4）：270-274.
6. 　Sarikouch S, Schaeffler R, Blanz U, et al. Adult congenital heart disease-double-chambered right ventricle. Clin Res Cardiol, 2007, 96 （8）：582-584.
7. 　Starr JP. Tetralogy of fallot：yesterday and today. World J Surg, 2010, 34 （4）：658-668.
8. 　Kottayil BP, Dharan BS, Pillai VV, et al. Surgical repair of doubl　e-chambered right ventricle in adulthood. Asian Cardiovasc Thorac Ann, 2011, 19 （1）：57-60.
9. 　Tao L, Zeng X. Right ventricular outflow tract patch reconstruction in anomalous origin of right coronary artery. Ann Thorac Surg, 2010, 89 （4）：1314-1316.
10. 　Mert M, Cetin G. Right ventricular outflow tract reconstruction for tetralogy of fallot with abnormal coronary artery：experience with 35 patients. J Card Surg, 2006, 21 （2）：131-136.
11. 　Yuan SM, Mishaly D, Shinfeld A, et al. Right ventricular outflow tract reconstruction：valved conduit of choice and clinical outcomes. J Cardiovasc Med, 2008, 9 （4）：327-337.
12. 　Spiewak M, Biernacka EK, Małek ŁA, et al. Right ventricular outflow tract obstruction as a confounding factor in the assessment of the impact of pulmonary regurgitation on the right ventricular size and function in patients after repair of tetralogy of Fallot. J Magn Reson Imaging, 2011, 33 （5）：1040-1046.
13. 　van de Woestijne PC, Mokhles MM, de Jong PL, et al. Right ventricular outflow tract reconstruction with an allograft conduit in patients after tetralogy of Fallot correction：long-term follow-up. Ann Thorac Surg, 2011, 92 （1）：161-166.
14. 　Kimberly AH, Dearani JA, Burkhart HM, et al. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg, 2011, 92 （1）：122-130.
15. 　Sullivan R, Huang GY, Meyer RA, et al. Heart malformations in transgenic mice exhibiting dominant negative inhibition of gap junctional communication in neural crest cells. Dev Biol, 1998, 204 （1）：224-234.
16. 　Butz T, Horstkotte D, Langer C, et al. Significant obstruction of the right and left ventricular outflow tract in a patient with biventricular hypertrophic　cardiomyopathy. Eur J Echocardiogr, 2008, 9 （2）：344-345.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

经右心房切口行右心室流出道疏通术

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