Shohtsu A, Takeuchi S, Sohma Y, Inoue T
J Cardiovasc Surg (Torino). 1976 Jan-Feb;17(1):13-19.
Sixty-four patients with large ventricular septal defects and severe pulmonary hypertension form the basis of this report. Prior to the end of 1970, 35 patients with a ratio of pulmonary to systemic artery pressure (pp/ps) of 0.8 or more were subjected to primary closure of the defect, resulting in 11 operative deaths Since the beginning of 1971, until March, 1974, however, the surgical results have markedly improved and 29 such patients were operated on without death. It has been our principle to perform elective closure of the defect at the age of 1 to 3 years. An earlier operation was planned when a decrease in the apical diastolic rumble and the size of the enlarged left ventricle on the chest x-ray were found on the periodical observation since infancey. If cardiac failure could not be controlled with medical treatment, primary closure of the defect has been performed even under one year of age.
本报告基于64例患有大型室间隔缺损和严重肺动脉高压的患者。在1970年底之前，35例肺动脉与体动脉压力比（pp/ps）为0.8或更高的患者接受了缺损的一期闭合手术，导致11例手术死亡。然而，自1971年初至1974年3月，手术结果有了显著改善，29例此类患者接受了手术且无死亡。我们的原则是在1至3岁时择期闭合缺损。如果在定期观察中发现自婴儿期起心尖舒张期隆隆音减弱以及胸部X线片上扩大的左心室尺寸减小，则计划进行更早的手术。如果药物治疗无法控制心力衰竭，即使在1岁以下也会进行缺损的一期闭合手术。
