Shinebourne E A, Tam A S, Elseed A M, Paneth M, Lennox S C, Cleland W P
Br Heart J. 1976 Apr;38(4):375-80. doi: 10.1136/hrt.38.4.375.
The management and results of treatment in 181 children with coarctation of the aorta are presented. In this series, 79% of the patients presented in the first year of life and 55% presented as neonates. One hundred and fifty patients were operated on, with a total surgical mortality of 21%. Only one surgical death occurred in those operated on after 3 months of age. The higher mortality in young infants is closely related to associated cardiac anomalies and to the frequency of aortic and isthmal hypoplasia. Our findings suggest that neonates presenting with heart failure and coarctation should be operated on early, as the surgical mortality under 6 weeks is 45%, whereas there is an 86% mortality in neonates who were not operated on. Analysis of follow-up indicates that when operation can be performed electively the optimal period for sugical treatment is between 6 months and 1 year of age. If operation is performed after this age, there may be persistent systemic hypertension despite relief of aortic obstruction.
本文介绍了181例主动脉缩窄患儿的治疗管理及结果。在该系列中，79%的患者在出生后第一年内发病，55%的患者为新生儿。150例患者接受了手术，手术总死亡率为21%。3个月龄后接受手术的患者仅发生1例手术死亡。婴儿期死亡率较高与相关心脏畸形以及主动脉和峡部发育不全的发生率密切相关。我们的研究结果表明，出现心力衰竭和主动脉缩窄的新生儿应尽早手术，因为6周龄以下婴儿的手术死亡率为45%，而未接受手术的新生儿死亡率为86%。随访分析表明，若能择期手术，手术治疗的最佳时期为6个月至1岁。若在此年龄之后进行手术，尽管主动脉梗阻已解除，但可能仍存在持续性系统性高血压。
