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find Keyword "肌部室间隔缺损" 3 results
  • Surgical Treatment of Muscular Ventricular Septal Defect in Infants with Multiple Ventricular Septal Defects

      Objective To investigate surgical strategy for the treatment of muscular ventricular septal defect (MVSD) in infants with multiple ventricular septal defects(VSD). Methods Clinical data of 46 infants with multiple VSD who underwent surgical repair in Shanghai Children’s Medical Center from January 2010 to April 2012 were retrospectively analyzed. There were 24 males and 22 females with their age of 8±6 months and body weight of 6.1±1.9 kg. All the patients received one-stage surgical repair,among whom MVSD of 10 patients was not found and repaired during the surgery. MVSD was repaired by surgical suture in 19 patients,hybrid repair under direct vision in 12 patients,and hybrid repair via the right ventricle in 5 patients. All the patients were regularly followed up after discharge by chest X-ray,ECG and color Doppler echocardiography to observe the closure of MVSD and the presence of residual shunt. Results All the 46 patients with multiple VSD survived their surgery without perioperative death. Three patients undergoing hybrid repair under direct vision received delayed sternal closure. One patient undergoing hybrid repair under direct vision had postoperative cardiac dysfunction. All the 46 patients were followed up for 1-17 months. Twenty-three patients had residual shunt of varying degrees during follow-up,and most of the MVSD of patients with residual shunt were <4 mm,who were receiving further follow-up and evaluation. Conclusion Appropriate surgical strategies can be applied according to specific surgical views during the operation for the treatment of MVSD in infants with multiple VSD,and satisfactory clinical outcomes can be achieved.

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • 心脏搏动下经右心室微创封堵婴幼儿肌部室间隔缺损

    目的探讨心脏搏动下经右心室微创封堵婴幼儿肌部室间隔缺损的临床效果。 方法回顾性分析2010年1月至2013年1月兰州大学第一医院心血管外科39例肌部室间隔缺损患儿行心脏搏动下经右心室微创封堵肌部室间隔缺损的临床资料,其中男26例、女13例,年龄10个月至3岁,体重6~15kg。应用经胸超声心动图进行术后随访,观察封堵器的位置,有无移位、有无残余分流、塑型情况及毗邻瓣膜是否开闭等。观察各瓣膜反流情况、各瓣膜口血流及房室腔的变化,心脏功能、肺动脉高压恢复情况等。 结果39例患儿中36例(92.3%)植入封堵器成功封堵,有3例患儿(7.7%)经食管彩色超声心动图(TEE)诊断不适宜行封堵治疗,其中1例由于右心室流出道有异常肌束,2例由于边缘过短不适宜行封堵手术,而改为体外循环下心内直视手术。36例患儿随访6个月以上,经胸超声心动图显示无封堵器脱落、移位,无溶血和房室传导阻滞,人工瓣膜表面光滑,无异物。心脏明显缩小,心功能正常,无神经系统并发症发生。其中3例术后存在轻微的残余分流,随访6个月均消失。 结论心脏搏动下经右心室微创封堵肌部室间隔缺损是肌部室间隔缺损一种较优的治疗选择,在经食管彩色超声心动图引导下手术是镶嵌治疗成功的关键,超声科医生与外科医生的合作是手术成功的基础。

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  • Hybrid Perventricular Closure for Pediatric Patients with Muscular Ventricular Septal Defect: Experience from West China Hospital

    ObjectiveTo investigate the efficacy and safety of hybrid perventricular device closure (PVDC) for the treatment of muscular ventricular septal defect (MVSD) in pediatric patients. MethodsWe retrospectively analyzed clinical data of 35 pediatric patients with MVSD who received hybrid PVDC in West China Hospital between 2009 and 2012. There were 16 males and 19 females with their median age of 3.9 years (range, 1 month to 7 years). There were 10 patients with single MVSD, 12 patients with multiple MVSD, 6 patients with other congenital heart defects, and 7 patients with post-surgical residual MVSD. ResultsAmong the 35 patients, immediate complete closure was achieved in 28 (80.0%) patients. Residual shunt was noted in 7 (20.0%) patients. Median device size was 5 mm. Cardiopulmonary bypass was avoided in 19 patients. Two (5.7%) patients died postoperatively due to postoperative heart failure resulted from complex congenital heart defect. All survival patients were followed up for a mean duration of 6 months, and there was no late death. Thirty-one (93.9%) patients had good positioning of the closure devices but no residual shunt. Small residual shunt at the apex was noted in 2 (6.1%) patients. ConclusionHybrid PVDC is an effective treatment for MVSD with relatively high successful rate but low mortality and morbidity, and its short-term results are satisfactory.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
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