Mistrot J, Neal W, Lyons G, Moller J, Lucas R, Castaneda A, Varco R, Nicoloff D
Ann Thorac Surg. 1976 Jan;21(1):30-7. doi: 10.1016/s0003-4975(10)64884-9.
One hundred ten patients were operated upon between 1961 and 1972 for isolated pulmonary stenosis by the inflow stasis technique. Analysis of the preoperative and postoperative clinical and catheterization data define the role of inflow stasis as an acceptable method of pulmonary valvulotomy except in relieving stenosis due to a dysplastic pulmonary valve. Patient ages ranged from 2 days to 36 years. All underwent preoperative catheterization and 69 (63%) were restudied postoperatively. Mean preoperative and postoperative peak systolic gradients were 93 and 23 mm Hg, respectively. Mean valve areas before and after operation were 0.38 and 1.10 cm2/m2. Operative mortality was 3.6% (4 patients), and there was 1 late death. Two of the dead were children 2 and 9 days old, respectively. Four patients required reoperation for residual gradients; 2 had dysplastic pulmonary valves. The overall results were excellent or good in 78%, fair in 15%, and poor in 7%. Patients with dysplatic pulmonary valves were in the poor or fair group, and it is recommended that the inflow stasis technique not be used for this type of pulmonary stenosis. The excellent surgical exposure, adequate time for valvulotomy, low morbidity, and freedom from problems of cardiopulmonary bypass are reasons for continued use of this technique for treatment of selected patients with pulmonary valve stenosis.
1961年至1972年间，110例患者采用血流淤滞技术接受了单纯肺动脉狭窄手术。对术前和术后的临床及心导管检查数据进行分析后发现，除了对发育异常的肺动脉瓣所致狭窄外，血流淤滞作为一种可接受的肺动脉瓣切开术方法具有一定作用。患者年龄从2天至36岁不等。所有患者均接受了术前心导管检查，69例（63%）术后再次接受检查。术前和术后平均收缩期峰值压差分别为93和23毫米汞柱。手术前后平均瓣膜面积分别为0.38和1.10平方厘米/平方米。手术死亡率为3.6%（4例患者），有1例晚期死亡。死亡的2例分别是2天和9天大的儿童。4例患者因残余压差需要再次手术；2例有发育异常的肺动脉瓣。总体结果为优或良的占78%，中等的占15%，差的占7%。发育异常的肺动脉瓣患者属于差或中等组，建议不将血流淤滞技术用于此类肺动脉狭窄。出色的手术暴露、充足的瓣膜切开时间、低发病率以及不存在体外循环问题，是继续将该技术用于治疗特定肺动脉瓣狭窄患者的原因。
