Norwood W I, Freed M D, Rocchini A P, Bernhard W F, Castaneda A R
Ann Thorac Surg. 1977 Sep;24(3):223-32. doi: 10.1016/s0003-4975(10)63747-2.
Dacron valved conduits or aortic allografts were placed between the right heart and the pulmonary artery for repair of various complex congenital cardiac anomalies in 56 patients (aged 15 days to 33 years; median, 11 years). Forty-four patients had a total of 56 previous palliative procedures, which contributed to postoperative morbidity and mortality. Six patients had a total of seven episodes of early or late sepsis involving the conduit. One patient, treated for early sepsis, again developed infection in the Hancock graft 1 year postoperatively and died. Three other patients, 2 with calcified allografts, developed infections 4 months to 7 years following repair and required graft replacement. Hemodynamic data 1 month to 5 years (mean, 1.6 years) following repair revealed mild to moderate obstruction (less than 45 mm Hg gradient) at the Hancock conduit valve ring in 13 of 19 patients, while 5 had large pressure gradients (greater than 75 mm Hg). All aortic allografts had severe obstruction and calcification necessitating graft replacement. It is anticipated that improved technique and appropriate timing of palliative and corrective operations will substantially reduce or eliminate these problems.
在56例患者（年龄15天至33岁；中位数为11岁）中，为修复各种复杂先天性心脏畸形，在右心与肺动脉之间植入了涤纶带瓣管道或主动脉同种异体移植物。44例患者此前共接受了56次姑息性手术，这导致了术后的发病率和死亡率。6例患者共发生7次涉及管道的早期或晚期脓毒症。1例接受早期脓毒症治疗的患者在术后1年， Hancock移植物再次发生感染并死亡。另外3例患者，其中2例的同种异体移植物发生钙化，在修复后4个月至7年发生感染，需要更换移植物。修复后1个月至5年（平均1.6年）的血流动力学数据显示，19例患者中有13例在Hancock管道瓣膜环处存在轻度至中度梗阻（压差小于45 mmHg），而5例存在较大压力阶差（大于75 mmHg）。所有主动脉同种异体移植物均存在严重梗阻和钙化，需要更换移植物。预计改进技术以及合理安排姑息性手术和矫正手术的时机将大幅减少或消除这些问题。
