Pulmonary valve commissure incision

When the congenital pulmonary valve annulus and right ventricular outflow tract are narrow, the pulmonary valve annulus can be severed along the longitudinal axis of the outflow tract, and then the patch is widened. If it can be cut along the right anterior-posterior valve junction of the pulmonary artery, it may reduce the degree of postoperative pulmonary regurgitation. Treatment of diseases: pulmonary valve insufficiency Indication Pulmonary stenosis, the valve area is less than 0.5cm2; the left ventricular peak pressure is greater than 75mmHg; the pulmonary artery-right ventricular pressure difference is greater than 50mmHg. Preoperative preparation 1. Eliminate all infected lesions. 2. Correct malnutrition, anemia, and liver, kidney, and other organ dysfunction. 3. Correct heart failure or put the patient in the best possible condition. 4. Stop the digitalis and diuretics 48 hours before surgery. 5. Use an ordinary diet 1 week before surgery to adjust the electrolyte balance. If the patient takes long-term diuretics, the oral potassium chloride should be increased in the first week before surgery to overcome the deficiency of potassium in the body. 6. Start antibiotics with antibiotics on the 3rd day before surgery. Give a dose of antibiotics when you use the medicine before surgery. 7. In severe cases, glucose, insulin and potassium chloride solution (gik) were intravenously administered 1 week before surgery to protect the myocardium. 8. Psychotherapy should be performed on patients before surgery to eliminate concerns and enhance cooperation between doctors and patients. Let the patient understand the various situations that may occur during the operation to facilitate the patient's active cooperation. Surgical procedure 1. The chest midline incision. 2. Longitudinal cut happy packets to verify and verify the diagnosis. 3. Establish extracorporeal circulation. 4. Make a longitudinal incision about 1.5 to 2.5 cm long above the pulmonary artery. 5. Retract the pulmonary artery incision and expose the pulmonary valve. 6. Cut along the junction , until the base of the valve. 7. Suture the pulmonary artery incision. complication When the congenital pulmonary valve annulus and right ventricular outflow tract are narrow, the pulmonary valve annulus can be severed along the longitudinal axis of the outflow tract, and then the patch is widened. If it can be cut along the right anterior-posterior valve junction of the pulmonary artery, it may reduce the degree of postoperative pulmonary regurgitation.

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