Chen Renwei,Luo Jinwen,Huang peng,et al. Effect of surgical intervention on complete atrioventricular block after interventional treatment of membranous ventricular septal defect.[J].Journal of Clinical Pediatric Surgery,2018,17(12):927-930.
外科干预在膜周部室间隔缺损介入术后房室传导阻滞的应用研究
- Title:
- Effect of surgical intervention on complete atrioventricular block after interventional treatment of membranous ventricular septal defect.
- Keywords:
- ; Heart Septal Defects; Ventricular; Interventional Therapy; Completely arioventricular Block; Surgical Procedures; Operative; Intervention
- 文献标志码:
- A
- 摘要:
- 目的分析外科手术取出封堵器，对于膜周部室间隔缺损（perimenbranous ventricular septal defect,pmVSD）介入治疗后早期发生完全性房室传导阻滞（complete atrioventricular block,CAVB）的作用。方法收集2006年10月至2016年8月于湖南省儿童医院经导管封堵介入治疗pmVSD术后早期发生CAVB且2周内行封堵器取出术的6例患儿临床资料。外科手术均在体外循环下进行，取出封堵器，补片修补室间隔缺损（ventricular septal defect，VSD），并矫正并发畸形。结果6例CAVB患儿中4例行三尖瓣隔瓣辅助切口；1例VSD行带垫间断褥式缝合，5例行连续缝合自体心包补片修补术；2例合并卵圆孔未闭同期修补。6例CAVB患儿行外科手术后窦性心律恢复时间1~41 h，平均25.4 h，2例因早期心动过缓，使用临时心脏起搏器。所有患儿随访1~6年，平均26.3个月，无1例发生死亡，心律及心功能基本正常，室间隔缺损修补处无残余分流，主动脉瓣及三尖瓣无明显反流。结论pmVSD经导管封堵介入术后发生CAVB的患儿需引起高度重视，及时外科手术治疗，有利于CAVB的恢复。
- Abstract:
- ObjectiveTo explore the effect of surgical removal of occluder on early occurrence of complete atrioventricular block (CAVB) after perimenbranous ventricular septal defect (pmVSD) interventional therapy and optimize the operative timing of CAVB after pmVSD interventional therapy.MethodsFrom October 2006 to August 2016,intervention therapy was performed.After interventional treatment,CAVB occurred in 14 cases and 6 cases had an early removal of occluder.Surgical procedures included cardiopulmonary bypass,removal of occluder,repair of ventricular septal defect (VSD) and correction of deformity.ResultsAmong 6 CAVB cases,4 underwent assisted incision for septal tricuspid valve;intermittent suturing by gasket (n=1) and continuous suturing by autologous pericardial patch (n=5).Two cases underwent simultaneous closure of foramen ovale.The mean postoperative recovery time of sinus rhythm time was 25.4(1-41) hours.Two cases had temporary cardiac pacing due to early bradycardia.The mean followup period was 26.3(1-6) years.There was no occurrence of death,residual shunt of VSD or obvious reflux in aortic and tricuspid valves.Both cardiac rhythm and function were normal.ConclusionPostoperation CAVB should be highly valued after pmVSD interventional treatment,and timely surgical treatment is beneficial to the recovery of CAVB.
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