小児期僧帽弁疾患に対する外科治療成績と問題点について

概要

論文の詳細を見る
A total of ninety-eight children underwent surgical treatment for mitral valvular disease from 1963 to June, 1984. Thirty-four patients (34.7%) (Congenital: 8, Aquired: 26) had mitral valve replacement, twenty patients (20%) had mitral valvuloplasty or mitral annuloplasty and forty-two patients with incomplete endocardial cushion defect (ECD) and two patients with complete forms of ECD had surgical repairs of the atrial septal defect and the mitral and tricuspid valve. The conclucions were as followes; 1) The first choice for surgical treatment for mitral valvular disease in children should be preservation of the natural valve by a conservative technique. 2) Prosthetic valve replacement in children is a life saving procedure, but the early failure in porcine heterograft valve replacement in children brought us to discontinue the routine use. 3) Surgical repair for mitral valve cleft with incomplete ECD should be performed in cases with a small regurgitation on angiocardiogram. Good repair reduced the incidence of cadriac failure and endocarditis in the postoperativd period. 4) We emphasized early primary repair of complete ECD in infancy because of un-controllable heart failure and early development of irreversibele pulmonary vascular obstructive disease.
日本小児外科学会の論文
1985-06-20