ZHANG Ze wei,QI Jian chuan,GAO Zhan,et al.Modified Carpentier’s repair technique in the treatment of Ebstein’s Anomaly: a Clinical Analysis of 18 Cases.[J].Journal of Clinical Pediatric Surgery,2010,9(06):404.
改良Carpentier法治疗Ebstein畸形
- Title:
- Modified Carpentier’s repair technique in the treatment of Ebstein’s Anomaly: a Clinical Analysis of 18 Cases.
- Keywords:
- Tricuspid Valve/AB; Heart Defects; Congenital/SU
- 文献标志码:
- A
- 摘要:
- 目的探讨改良Carpentier法治疗Ebstein畸形的疗效与经验。 方法回顾性分析2003年6月至2009年10月本院手术治疗的18例Ebstein心脏畸形患儿的临床资料。18例均予改良Carpentier法手术矫治，在Carpentier法手术矫治的基础上，后瓣叶边缘对合缝在隔瓣叶或前瓣，以加大面积；同期矫治合并畸形。结果17例存活，1例因术后并发心律失常持续低氧血症而死亡。存活患儿术后心功能I级，均痊愈出院，其中1例术后出现Ⅲ°房室传导阻滞，3个月后转窦性心律。存活患儿均获随访，随访时间6～62个月，生长发育正常。结论运用改良Carpentier法行三尖瓣成形术治疗Ebstein畸形，右心室功能恢复良好，效果满意，保全了右心室心尖至心底部的长度，是目前较为理想的手术方式。
- Abstract:
- ObjectiveTo evaluate the efficacy of surgical treatment of Ebstein's anomaly with modified Carpentier’s repair technique.MethodsWe analyzed 18 patients received corrective surgery for Ebstein’s anomaly from Jun．2003 to Oct．2009；All of them treating Ebstein’s anomaly with modified Carpentier's repair technique，the edge of posterior leaflet was sewed to the edge of anterior leaflet or septal leaflet in favor of enlarging the area of leaflet．Associated heart lesions were corrected at the same time.ResultsThere were one patient died of hypoxemia and arrhythmia. Complete heart block occurred in one patient. Survivors were followed up for 6 months to 62 months．No late death occurred．ConclusionsIn the Treatment of Ebstein’s Anomaly，The modified Carpentier’s repair technique that preserving the apextobase dimension of the right entricle ,is feasible and possesses a good outcome.
参考文献/References:
1刘迎龙.Ebstein心脏畸形\[M\]//朱晓东,张宝仁.心脏外科学.北京：人民卫生出版社，2007:457—462.2Mann RJ,Lie JT.The life story of Wilhelm Ebstein(1836-1912)and his almost overlooked description of a congenital heart disease\[J\].Mayo clin Proc,1979,54:197.3汪曾炜．Ebstein心脏畸形\[M\]//汪曾炜，刘维永，张宝仁．心脏外科学．北京：人民军医出版社，2003：1086—1112.4Schreiber C,Cook A,Ho SY,et al．Morphologic spectrum of Ebstein'S malformation: revistation relative to surgical repair\[J\]．Thorae Cardiovasc Surg，l999，l19：148—155．5吴清玉，张怀军，许建屏．108例三尖瓣下移的矫治\[J\]．中华外科杂志，1999，37(11)：663—665．6Danielson GK，Driscoll DJ，Mair DD，et al．Operative treatment of Ebstein's anomaly\[J\]．J Thorac Cardiovasc Surg，1992，104(5)：1195—1202.7Carpentier A，Chauvaud S，Mace L，el al．A new reconstruetive operation for Ebstein S anomaly of the tricuspid valve\[J\]．J Thorac Cardiovasc Surg，1988，96(1)：92—101.8Cherian SM .Varghese R. Sankar NM.et al.DeVega’s tricuspid annuloplasty for Ebstein’S anomaly\[J\]．Cardiovasc Surg(Torino)，2003,44(2)；213—215.9杜亮，郭兰敏．Ebstein畸形中三尖瓣的解剖特征及其临床意义\[J\]．中国临床解剖学杂志，2000，18(2)：121—123.10许建平，高峰，吴清玉.三尖瓣下移畸形的外科治疗\[J\].中华胸心血管外科杂志，2005,21（6）：368—369.11Marianeschi SM，McElhinney DB，Ready VM，et al．Alternative approach tO the repair of Ebstein rs malformation：intracardiac repair with ventricular unloading\[J\]．Ann Thorac Surg,1998,66(5):1546—1550．
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备注/Memo
Email:zeweiz@zju.edu.cn