| Japanese |
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| Title | ファロー四徴症を合併した完全型心内膜床欠損症に対する外科治療の検討 |
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| Subtitle | 原著 |
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| Authors | 萩野生男 |
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| Authors(kana) | |
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| Organization | 東京女子医科大学付属日本心臓血圧研究所循環器小児外科学教室 |
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| Journal | 循環制御 |
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| Volume | 21 |
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| Number | 4 |
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| Page | 445-449 |
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| Year/Month | 2000/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 1984年から2000年にかけて10例のファロー四徴症を合併した完全型心内膜床欠損症に対し根治術を施行し, その成績について検討した. 手術時平均年齢(±SD)は9.5才(±8.7), 平均体重(±SD)は26.5kg(±17.6)であった. 5例に体肺動脈短絡術の既往歴があり, Down症候群の合併例は5例であった. 心室中隔欠損孔と心房中隔欠損孔は2パッチ法を用いて閉鎖し, 心室中隔欠損孔の閉鎖はコンマ型パッチを使用して7例は右房と右室から, 3例は右房から施行した. 左側前後架橋弁尖の裂隙は閉鎖した. 右室流出路狭窄の解除は, 異常筋束の切除切離に加え, 9例は1弁付きパッチを用い(7例;自己心膜製), 1例は漏斗部パッチを使用して施行した. 2例の院内死亡を認め, 死因は2例とも低拍出量症候群(LOS)であった. 遠隔期死亡は認めず, 中等度以上の左側房室弁閉鎖不全症は2例に認め1例は術後10ヵ月時に弁置換術を施行した. 右室流出路における圧較差は平均(±SD)19.6±18.1mmHgであった. 自己心膜製1弁付きパッチを利用した右室流出路狭窄の積極的な解除と肺動脈弁閉鎖不全の防止, 房室弁の閉鎖不全を来さない再建が早期および長期の成績を良好にすると考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Complete atrioventricular septal defect, Tetralogy of Fallot, Mitral cleft, Monocusp autologous pericardial patch |
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| English |
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| Title | Repair of Complete Atrioventricular Septal Defects with Tetralogy of Fallot |
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| Subtitle | |
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| Authors | Ikuo Hagino |
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| Authors(kana) | |
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| Organization | Departmentment of Pediatric Cardiovascular Surgery The Heart Institute of Japan,Tokyo Women's Medical University |
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| Journal | Circulation Control |
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| Volume | 21 |
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| Number | 4 |
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| Page | 445-449 |
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| Year/Month | 2000/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Between 1984 and 2000, 10 patients with complete atrioventricular septal defects with tetralogy of Fallot underwent surgical repair. The mean age at operation was 9.5 years, and the mean body weight 26.5 kg. Five patients underwent 5 systemic-pulmonary shunts respectively. Five patients had Down's syndrome. The ventricular septal defect was closed through a right atrial and right ventricular approach in seven patients, and through a right atrial approach in three patients, using a comma-shaped prosthetic patch. The atrial septal defect was closed with a separate patch. The left anterior and posterior leaflets were sutured together using multiple interrupted stitches. Right ventricular outflow obstruction was relieved by a infundibular patch (one case), monocusp equine pericardial patch (two) or monocusp autologous pericardial patch (seven). There were two hospital death (20%), caused by low cardiac output in both cases. There was no late mortality. In the long-term follow-up study (0.7-16.1 yeaers, mean 5.1±5.6), right ventricular outflow tract gradient ranged between 0 and 41 mmHg (mean, 19.6±18.1). Two patients had mitral regurgitation; I needed reoperation. It was concluded that our techniques for this lesion contribute to satisfactory immediate and long-term results after repair. |
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| Practice | Basic medicine |
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| Keywords | Complete atrioventricular septal defect, Tetralogy of Fallot, Mitral cleft, Monocusp autologous pericardial patch |
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