Landau J F, Lafay F, Batisse A, Kachaner J, Marchand M, Hazan E, Neveux J Y
Arch Mal Coeur Vaiss. 1979 May;72(5):462-9.
Complete repair was undertaken in 28 infants with severe forms of tetralogy of Fallot because severe cyanosis or anoxic spells. Age at operation ranged from 8 days to 11 months (mean: 4,4 months). Among the 24 cases without any other intracardiac defect, there were 6 early deaths related in 4 cases to a wrong indication or a technical error. Re-investigation was performed in 14 out of the 18 survivors from 3 weeks to 6 months post-operatively: the result is good in 10 cases, fair in 1 case, and poor in 3 cases requiring twice a reoperation with 1 further death and 1 good final result. More accuracy in selecting the surgical patients and improvement in operative techniques should result in a further decrease of our early mortality rate. Primary complete repair should therefore become a substantial alternative to the palliative shunts which results seem to be hazardous in the more severe types of the defect.
28例患有严重法洛四联症的婴儿因严重紫绀或缺氧发作接受了完全修复手术。手术年龄从8天至11个月不等(平均:4.4个月)。在24例无其他心内缺陷的病例中,有6例早期死亡,其中4例与错误的手术指征或技术失误有关。18名幸存者中有14名在术后3周-6个月进行了复查:结果良好的有10例,尚可的有1例,不佳的有3例,这3例需要再次手术,其中1例再次手术后死亡,1例最终结果良好。在选择手术患者时提高准确性并改进手术技术应能进一步降低我们的早期死亡率。因此,对于姑息性分流术而言,一期完全修复应成为一种切实可行的替代方案,因为在更严重类型的缺陷中,姑息性分流术的结果似乎很危险。