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目的总结14例小儿三房心合并其他心脏畸形的外科治疗经验。方法全组均在中度低温体外循环下进行手术,平均年龄(5.6±3.5)岁,单纯型1例,复杂型13例(完全型11例,非完全型3例)。采用右房-房间隔径路显露左心房纤维隔膜,仔细辨认其解剖关系,充分剪除纤维隔膜疏通左心房通道,保护好二尖瓣膜。采用自体心包补片尽量扩大左心房容积,同时彻底矫正合并的其他心脏畸形。结果无一例手术死亡,14例全部存活,随访5个月~5年,心功能正常。结论三房心手术治疗取得早期和晚期良好疗效,手术关键在于仔细辨认,彻底矫正合并畸形。
Objective To summarize the experience of surgical treatment of 14 cases of infantile three-room heart combined with other cardiac malformations. Methods All patients underwent moderate hypothermic cardiopulmonary bypass with an average age of 5.6 ± 3.5 years. There were 1 simple type and 13 complicated type (11 complete type and 3 incomplete type). The right atrial - atrial septal path revealed left atrial fibrillation membrane, carefully identify the anatomical relationship, and fully cut off the fibrous septum to clear the left atrial access to protect the mitral valve. The use of self-pericardial patch try to expand the left atrium volume, while completely correcting the merger of other heart malformations. Results None of the patients died of surgery, and all 14 patients survived. The patients were followed up for 5 months to 5 years and their heart function was normal. Conclusion The three-room heart surgery achieved early and late good curative effect. The key of the operation is careful identification and complete correction of deformity.