Macartney F J, Scott O, Ionescu M I
Am Heart J. 1975 Feb;89(2):195-9. doi: 10.1016/0002-8703(75)90046-0.
Eight patients were catheterized between 1.2 and 2.4 years after reconstruction of the right ventricular outflow tract with autologous fascia lata. Whereas the immediate post-bypass pressures had demonstrated a maximum gradient of 15 mm. Hg across the fascial valve at the time of recatheterization, this varied from 55 to 142 mm. Hg (mean 83 mm. Hg). Right ventricular systolic pressure varied between 80 and 160mm. Hg (mean 106 mm. Hg). All but one patient had clinical evidence of pulmonary incompetence. Selective angiography with injection into the right ventricle and pulmonary artery demonstrated shrunken, thickened, immobile valve cusps with an abrupt stenosis of the fascial tube or a diaphragm across it. Re-operation has been done in five patients. In each, the graft tube functioned satisfactorily, but at the site of the "valve," no leaflets were visible, and the orifice of the conduit narrowed abruptly to 6 to 10 mm. in diameter. It is concluded that autologous fascia lata is unsuitable for reconstruction of the right ventricular outflow tract.
8例患者在采用自体阔筋膜重建右心室流出道后1.2至2.4年接受了心导管检查。在再次进行心导管检查时，尽管体外循环后即刻的压力显示穿过筋膜瓣的最大压差为15毫米汞柱，但此时该压差在55至142毫米汞柱之间变化（平均83毫米汞柱）。右心室收缩压在80至160毫米汞柱之间变化（平均106毫米汞柱）。除1例患者外，所有患者均有肺动脉瓣关闭不全的临床证据。向右心室和肺动脉注射造影剂进行的选择性血管造影显示，瓣膜尖收缩、增厚、活动受限，筋膜管出现突然狭窄或有膈膜横跨。5例患者接受了再次手术。在每例患者中，移植管功能良好，但在“瓣膜”部位未见瓣叶，管道开口直径突然缩小至6至10毫米。结论是自体阔筋膜不适合用于重建右心室流出道。
