Sequelae of atriotomy and ventriculotomy on the endocardium, conduction system and coronary arteries.
Sequelae of atriotomy and ventriculotomy on the endocardium, conduction system and coronary arteries.
复制标题
心房切开术和心室切开术对心内膜、传导系统和冠状动脉的后遗症。
DOI：
10.1016/0002-9149(82)90327-7
复制
发表时间：
1982
期刊：
影响因子：
--
通讯作者：
M. Lev
中科院分区：
文献类型：
--
作者：
S. Bharati;M. Lev
对99例死亡前6周以上接受外科修复的各种类型先天性心脏病患者的四个心腔的心内膜进行了分析。这一发现与相似年龄段的正常心脏进行了比较。在某些情况下，心内膜进行了显微镜检查。这项研究表明，在许多情况下，所有四个腔室都有心内膜纤维弹力纤维增生症(无论以前做过的手术类型是什么，都是弥漫性的)。这些数据表明，弥漫性纤维弹力纤维增生症可能是手术干预的结果，可能与淋巴引流受阻有关。一些先天性心脏病患者在手术后很长一段时间内突然死亡，一些病例在完全手术修复后房室未能恢复到正常大小，这可能与房室纤维弹力增生症有关。在房室切开和Mustard手术中，窦房结可能会受到损伤。脑室切开术可能会损伤右束支。室壁切开术也可能损害右心室的冠脉供应，或罕见的冠脉前降支。
The endocardium was analyzed in all four chambers of 99 hearts with various types of congenital heart defects in which surgical repair was performed more than 6 weeks before death. The findings were compared with those of normal hearts in similar age groups. In some cases the endocardium was microscopically examined. This study revealed that in many cases all four chambers had fibroelastosis of the endocardium (diffuse regardless of the type of surgery done previously). These data suggest that diffuse fibroelastosis can occur as a result of surgical intervention and may be related to blocked lymphatic drainage. Sudden death in some patients long after surgery for congenital heart disease and the failure of the chambers to regress to normal size in some cases after total surgical repair may be related to fibroelastosis of the chambers.The sinoatrial node may be injured in atriotomy and in the performance of the Mustard procedure. Ventriculotomy may injure the right bundle branch. Ventriculotomy may also injure the coronary supply to the right ventricle or rarely the anterior descending coronary artery.