FOURON J C, STANLEY P, FAVREAU-ETHIER M, DAVIGNON A
Can Med Assoc J. 1964 Sep 26;91(13):694-700.
Twenty-seven infants with ventricular septal defects and in cardiac failure were followed regularly under medical treatment for an average period of 17 months. The diagnosis was proved in all cases by cardiac catheterization. At the end of the follow-up period, the patients could be classified as follows: Sixteen patients showed no change in their cardiovascular status, and six had signs of pulmonary infundibular stenosis. One child had died from bronchopneumonia. Another was classified as having probable functional closure of the defect. Finally, three other children, because of failure of medical treatment, underwent banding of the pulmonary artery. One died during the operation. It is concluded that the great majority of patients with ventricular septal defects and cardiac failure can be carried successfully under medical management until the age at which corrective surgery is feasible. Palliative procedures which in themselves carry a fairly high mortality risk should be used only as a last resort.
27例患有室间隔缺损且伴有心力衰竭的婴儿接受了定期药物治疗,平均治疗时间为17个月。所有病例均通过心导管检查确诊。随访期末,患者可分为以下几类:16例患者心血管状况无变化,6例有肺动脉漏斗部狭窄体征。1名儿童死于支气管肺炎。另1例被归类为缺损可能已功能性闭合。最后,另外3名儿童因药物治疗无效,接受了肺动脉束带术。其中1例在手术中死亡。结论是,绝大多数患有室间隔缺损和心力衰竭的患者在药物治疗下可成功维持至可行矫正手术的年龄。本身具有相当高死亡风险的姑息性手术应仅作为最后手段使用。