目的 探讨不剪开共同瓣"双片法"治疗小于5 kg完全房室隔缺损手术效果.方法 我科2002年1月～2007年6月采用不剪开共同瓣"双片法"治疗小于5 kg完全房室隔缺损15例.平均年龄(3.4±0.7)个月,平均体重(4.4±0.2)kg.术前房室共同瓣轻度反流2例、中度反流10例,重度反流3例.所有患儿均为RastelliA型.2例合并Down综合征.结果 1例死于严重左侧房室瓣反流.1例一过性血红蛋白尿,1例Ⅰ度房室传导阻滞,无一例发生完全房室传导阻滞.随访时间(1.9±0.3)年,无一例死亡,心电图检查无一例发生完全房室传导阻滞,心脏超声示二尖瓣轻度反流2例,轻～中度反流2例,未见心室水平残余分流和左室流出道狭窄.结论 小于5kg完全房室隔缺损患儿可以不剪开共同瓣行"双片法"Ⅰ期根治.%Objective To evaluate the therapeutic effect of non-surgical division of the bridging leaflets using the double-patch technique on patients with complete atrioventricular septal defect (CAVSD)weighing less than 5 kg at operations.Methods From January 2002 to June 2007,15 consecutive patients with CAVSD underwent primary repair using a two-patch technique with no surgical division of the bridging leaflets,with the mean age of 3.4±0.7 months(ranging from 2 to 6 months)and with the mean body weight of 4.4±0.2 kg(ranging from 3.75 to 5.0 kg).Preoperative echocardiographic atrioventricular valve regurgitation was mild in 2 cases,moderate in 10 and severe in 3.All patients were type A according to the Rastelli classification.Two patients(13.3%)got the complication of Down's syndrome.Results One patient died of severe left atrioventricular valve regurgitation (LAVVR).One patient had temporary hemoglobinuria,and 1 patient had I°atrioventricular block.None got complete atrioventricular block.The mean follow-up period was 1.92±0.25 years(ranging from 0.5 to 3 years).Follow-up electrocardiography showed that all patients remained in sinus rhythrm Two cases had mild LAVVR,and 2 cases had mild to moderate LAVVR.No patients got residual ventricular septal defect and left ventricular outflow tract obstruction by cross-sectional echocardiography.Conclusions We may conclude that repair of CAVSD with no surgical division of the bridging leaflets can be carried out successfully in patients weighing less than 5 kg.
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