3."缘对缘"瓣膜成形在先天性房室管畸形中的应用

Background.Atrioventricularvalveregurgitationrepresentstheprincipalindicationforreoperationafterrepairofatrioventricularseptaldefect.Decidinghowtocorrectatrioventricularvalveregurgitationischallenginginsomecasesbecauseofthecomplexityoftheanatomicfeatures.Thisreportdealswithoursurgicalexperienceinusingadouble-orificevalveplastytechniqueincaseswithatrioventricularseptaldefect.

Methods.FromAugust2002toAugust2004,8patientsunderwentdouble-orificevalveplastyinsurgicalcorrectionofatrioventricularseptaldefect.Anatomictypeswerepartial（6patients）,intermediate（1patient）,andcomplete（1patient）.Afterthemitralcleftwasclosed,moderatetosevereatrioventricularvalveregurgitationwasstillpresentinthesepatients.Double-orificevalveplastywasusedinthemitralvalvein7patientsandinthetricuspidvalvein1.

Results.Nohospitaldeathsorpostoperativemorbidityoccurred.Thefollow-uprangedfrom6monthsto30months（median,14.4months）.Noortrivialatrioventricularvalveregurgitationwasfoundin6patientsandmildatrioventricularvalveregurgitationwaspresentin2.

Conclusions.Double-orificevalveplastyisaneasyandeffectiveadditionalprocedureforchildrenandforadultpatientswhohavemoderateorsevereatrioventricularvalveregurgitationafterrepairofatrioventricularseptaldefect.