Watkins L, Donahoo J S, Harrington D, Haller J A, Neill C A
Ann Thorac Surg. 1977 Dec;24(6):498-507. doi: 10.1016/s0003-4975(10)63448-0.
Pulmonary valvular stenosis secondary to congenital valve dysplasia differs markedly from the classic variety of pulmonary stenosis. The reported mortality of patients treated by standard commissurotomy is 38 to 66%. The clinical features and operative management of 14 patients with dysplastic pulmonary valves are reviewed. Three groups of patients were studied. Group 1 consisted of 5 patients treated by commissurotomy. Group 2 comprised 3 patients treated by partial excision of the valve. In neither group were there operative deaths, but 5 of the 8 patients developed recurrent stenosis; 3 required reoperation. In 1975, because of the high incidence of recurrent stenosis, total valvectomy was begun. Ten patients (Group 3) have undergone valvectomy with 1 death. Nine patients were doing well at 3 to 15 months of follow-up. Based on the reported mortality and present findings, total excision of the valve is recommended for relief of stenosis in pulmonary valve dysplasia.
继发于先天性瓣膜发育异常的肺动脉瓣狭窄与典型的肺动脉狭窄有显著差异。据报道，接受标准瓣膜切开术治疗的患者死亡率为38%至66%。本文回顾了14例发育异常肺动脉瓣患者的临床特征及手术治疗情况。研究对象分为三组。第一组包括5例接受瓣膜切开术治疗的患者。第二组由3例接受瓣膜部分切除术治疗的患者组成。两组均无手术死亡，但8例患者中有5例出现复发性狭窄；3例需要再次手术。1975年，由于复发性狭窄的发生率较高，开始进行全瓣膜切除术。10例患者（第三组）接受了瓣膜切除术，1例死亡。9例患者在随访3至15个月时情况良好。基于报道的死亡率和目前的研究结果，建议对发育异常的肺动脉瓣狭窄患者进行瓣膜全切除以缓解狭窄。
