Albanese S B, Carotti A, Di Donato R M, Mazzera E, Troconis C J, Giannico S, Picardo S, Marcelletti C
Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale Bambino Gesù, Rome, Italy.
J Thorac Cardiovasc Surg. 1992 Oct;104(4):904-9.
Between December 1986 and December 1990, a bidirectional cavopulmonary anastomosis was performed in 27 patients younger than 2 years of age, including 12 with heterotaxia syndrome. Age and weight of patients averaged 14.2 +/- 6.6 months and 8.1 +/- 2.2 kg, respectively. Eleven had pulmonary atresia and 16 had pulmonary stenosis. The main pulmonary artery was ligated in seven patients in the latter group (subsequently reopened in one) and left open in nine (subsequently ligated in two). There were four hospital deaths (15%). All patients were discharged with anticoagulant/antithrombotic therapy to be continued for 6 months. There were two late deaths before further operations (8.7%). Two patients, one with acquired massive pulmonary arteriovenous fistulas and one with progressive common atrioventricular valve regurgitation, subsequently underwent definitive repair (biventricular in one), and both died. Heterotaxia syndrome (p = 0.087) and preoperative mean pulmonary artery pressure higher than 15 mm Hg (p = 0.09) were the only risk factors for overall mortality.
1986年12月至1990年12月期间，对27例2岁以下患儿实施了双向腔肺吻合术，其中12例患有异构综合征。患儿的平均年龄和体重分别为14.2±6.6个月和8.1±2.2千克。11例患有肺动脉闭锁，16例患有肺动脉狭窄。后一组中有7例患者的主肺动脉被结扎（其中1例随后重新开放），9例保持开放（其中2例随后被结扎）。有4例患者在医院死亡（15%）。所有患者出院时均接受抗凝/抗血栓治疗，并持续6个月。在进一步手术前有2例晚期死亡（8.7%）。2例患者，1例患有后天性大量肺动静脉瘘，1例患有进行性共同房室瓣反流，随后接受了确定性修复（其中1例为双心室修复），两人均死亡。异构综合征（p = 0.087）和术前平均肺动脉压高于15 mmHg（p = 0.09）是总体死亡率的唯一危险因素。
