MUSTARD W T, TRUSLER G A, YAO J
Can Med Assoc J. 1963 Nov 23;89(21):1068-71.
Forty-seven infants and children, aged from one month to 15 years, were operated upon during the past six years at the Hospital for Sick Children, Toronto, using extracorporeal circulation. Retrograde cardiac catheterization of the left ventricle with a pull-through tracing across the valve is important in selection of candidates for operation. Patients with a pressure gradient of over 45 mm. Hg require operation. In this series, valvular stenosis was the condition most commonly encountered; subvalvular membranous stenosis was present in eight patients, and muscular subvalvular stenosis in four. There was one operative death in an infant with multiple anomalies, and one late death from subacute bacterial endocarditis two years after operation. It is suggested that early operative treatment in cases of aortic stenosis in infancy and childhood might lessen the incidence of calcific aortic stenosis in adult life.
在过去六年中，多伦多病童医院对47名年龄从1个月至15岁的婴幼儿及儿童进行了体外循环手术。通过逆行心脏导管插入术对左心室进行操作，并在瓣膜上进行拉动式描记，这对于选择手术候选者很重要。压力梯度超过45毫米汞柱的患者需要进行手术。在这个系列中，瓣膜狭窄是最常见的病症；8名患者存在瓣膜下膜性狭窄，4名患者存在肌肉性瓣膜下狭窄。一名患有多种畸形的婴儿术中死亡，一名患者术后两年因亚急性细菌性心内膜炎晚期死亡。有人认为，婴幼儿和儿童期主动脉狭窄的早期手术治疗可能会降低成年后钙化性主动脉狭窄的发生率。
