...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of cardiac surgery. >Pulmonary vascular protective mechanisms in adult patients with an isolated large ventricular septal defect: a 21-year experience.
【24h】

Pulmonary vascular protective mechanisms in adult patients with an isolated large ventricular septal defect: a 21-year experience.

机译：具有孤立的大室间隔缺损的成年患者的肺血管保护机制：21年的经验。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Ventricular septal defects (VSDs) are one of the most common congenital heart defects in adults. In adult patients with an anatomically large VSD and relatively preserved pulmonary vascular system, several pulmonary flow-limiting cardiac morphologic alterations (PFMA) are encountered. PATIENTS: Ninety-eight male patients (mean age 22.5 +/- 2 years) operated for an anatomically large VSD in our institution were retrospectively reviewed. PFMA in patients with an anatomically large but functionally mild-to-moderate VSD (when ratio of pulmonary to systemic flow (Q(p)/Q(s)) < 2.2 and ratio of pulmonary to systemic vascular resistance (R(p)/R(s)) < 0.3) were recorded. RESULTS: Thirty patients (31.2%) revealed a mild-to-moderate VSD in functional severity. Five PFMA were encountered in these patients: (1) ostium (os) infundibulum (n = 10, 33.3%), (2) aneurysm of the membranous septum (AMS) (n = 10, 33.3%), (3) systolic bulging of the conal septum toward the right ventricular outflow tract (n = 6, 20%), (4) prolapse of the aortic cusps (n = 2, 6.7%), and (5) attachment of the tricuspid septal leaflet to the septal crest (n = 2, 6.7%). Double-chambered right ventricle was encountered in four patients with os infundibulum and classic tetralogy-type septal malalignment in one patient with aortic cusp prolapse. Concurrent to VSD repair, resection of the os infundibulum and the AMS and aortic valve repair were performed. CONCLUSION: Presence of a large VSD and relatively preserved pulmonary vascular system in adults is associated with several PFMA. Preoperative awareness and concurrent surgical treatment of these alterations seem to be crucial to improve the expected benefit of surgical repair of VSD in this subgroup of the patients.
机译：背景：室间隔缺损（VSDs）是成人中最常见的先天性心脏缺损之一。在解剖学上较大的VSD和相对保存的肺血管系统的成年患者中，遇到了几种限制肺流量的心脏形态学改变（PFMA）。患者：回顾性分析了本机构接受解剖学上较大的VSD手术的98例男性患者（平均年龄22.5 +/- 2岁）。解剖上较大但功能轻度至中度VSD（当肺与全身血流之比（Q（p）/ Q（s））<2.2和肺与全身血管阻力之比（R（p）/记录R（s）<0.3）。结果：30名患者（31.2％）表现出轻度至中度VSD的功能严重程度。这些患者遇到五种PFMA：（1）漏斗口（os）（n = 10，33.3％），（2）膜中隔（AMS）的动脉瘤（n = 10，33.3％），（3）收缩期鼓胀圆锥形隔膜向右心室流出道方向移动（n = 6，20％），（4）主动脉尖突脱垂（n = 2，6.7％），以及（5）三尖瓣隔膜小叶附着在隔膜c上（n = 2，6.7％）。在四名漏斗性骨and骨病患者中遇到了双室右心室，而在一名主动脉瓣尖脱垂的患者中出现了经典的四联征型间隔不整齐。在VSD修复的同时，进行漏斗骨和AMS的切除以及主动脉瓣的修复。结论：成人存在较大的VSD和相对保存完好的肺血管系统与几种PFMA有关。对这些改变的术前了解和同时进行的外科治疗似乎对于提高该亚组患者的VSD手术修复的预期获益至关重要。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号