Arab S M, Kholeif A F, Zaher S R, Abdel-Mohsen A M, Kassem A S, Qureshi S A
Cardiology Department, Alexandria University, Main University Hospital, Egypt.
Cardiol Young. 1999 Jan;9(1):11-6. doi: 10.1017/s1047951100007320.
Fifteen patients requiring palliation for tetralogy of Fallot were treated by balloon dilation because of hypercyanotic spells. The mean age at dilation was 1.9 +/- 0.7 years (range 0.5-3), and the mean weight 9.8 +/- 2.1 kg (range 6.0-13.5). Dilation of the outflow tract was combined with dilation of the left and/or right pulmonary arteries in 5 patients. Successful dilation was achieved in 12 patients (80%), but failed in 3 patients with hypoplastic pulmonary arteries. In one patient, the stenosis of the right pulmonary artery could not be dilated because of a very sharp angle at the site of the stenosis. Two of the 3 patients in whom the procedure failed died of severe cyanotic spells within 24 hours of the unsuccessful procedure. No major complications occurred during or after the procedure in the cases undergoing successful dilation. The arterial oxygen saturation increased significantly, from 71 +/- 5.7% to 89 +/- 3.9%, immediately after the procedure (p < 0.005). During a period of follow up of 6 +/- 3.7 months (range 1-13), the procedure was repeated on 3 occasions, and successfully accomplished in 2 of these. In conclusion, balloon dilation is a satisfactory palliative procedure for tetralogy of Fallot in those units in which total correction is not performed under 2 to 3 years of age.
15例因法洛四联症需要姑息治疗的患者因缺氧发作接受了球囊扩张术。扩张时的平均年龄为1.9±0.7岁（范围0.5 - 3岁），平均体重9.8±2.1千克（范围6.0 - 13.5千克）。5例患者的流出道扩张与左和/或右肺动脉扩张相结合。12例患者（80%）扩张成功，但3例肺动脉发育不全的患者扩张失败。1例患者因狭窄部位角度非常锐利，右肺动脉狭窄无法扩张。手术失败的3例患者中有2例在手术失败后24小时内死于严重缺氧发作。成功扩张的病例在手术期间或术后未发生重大并发症。术后动脉血氧饱和度立即从71±5.7%显著提高到89±3.9%（p < 0.005）。在6±3.7个月（范围1 - 13个月）的随访期间，该手术重复进行了3次，其中2次成功完成。总之，对于那些在2至3岁以下不进行根治性矫正的单位，球囊扩张术是法洛四联症令人满意的姑息治疗方法。
