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目的探讨嵌合肺动脉瓣成形术在法洛氏四联症(TOF)手术重建右心室流出道的应用及临床疗效。方法回顾性分析山东大学附属省立医院2011年9月至2016年6月应用嵌合肺动脉瓣成形术重建TOF患者右心室流出道42例患者临床资料。该术式设计梯形补片嵌合入自体肺动脉前瓣,重建肺动脉瓣环,修复瓣叶对合面积不足。随访3~52个月,采用经胸超声心动图评价肺动脉瓣反流程度。结果采用嵌合肺动脉瓣成形术重建右室流出道,近中期临床效果满意,肺动脉瓣反流程度均低于中度。结论对于肺动脉瓣环严重狭窄和肺动脉瓣叶发育不良的TOF患者,嵌合肺动脉瓣成形术有助于改善术后肺动脉瓣反流程度。
Objective To investigate the application and clinical efficacy of chimeric pulmonary valvuloplasty in the reconstruction of right ventricular outflow tract in patients with tetralogy of Fallot (TOF) surgery. Methods The clinical data of 42 patients with right ventricular outflow tract from TOF patients who underwent chimeric pulmonary valvuloplasty from September 2011 to June 2016 in Provincial Hospital of Shandong University were retrospectively analyzed. The surgical design of trapezoidal patch fitted into the anterior pulmonary valve, the reconstruction of the pulmonary valve annulus, prosthetic leaf area to repair the insufficiency. The patients were followed up for 3 to 52 months. The degree of pulmonary valve regurgitation was evaluated by transthoracic echocardiography. Results The chimeric pulmonary valvuloplasty was used to reconstruct the right ventricular outflow tract. The clinical results were satisfactory in the near and mid-term, and the degree of pulmonary valve regurgitation was lower than that of moderate. Conclusions For TOF patients with severe pulmonary valve stenosis and poorly developed pulmonary valve leaflets, chimeric pulmonary valvuloplasty can help to improve the degree of postoperative pulmonary valve regurgitation.