Gupta Anuja, Odim Jonah, Levi Daniel, Chang Ruey-Kang, Laks Hillel
Division of Pediatric Cardiology, UCLA Medical Center, USA.
J Thorac Cardiovasc Surg. 2003 Dec;126(6):1746-52. doi: 10.1016/s0022-5223(03)01200-5.
To determine the early and intermediate-term outcome of the staged repair used to treat children with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries.
We reviewed a retrospective case series of 104 patients with this complex lesion. Information was obtained from medical records and referring physicians.
Of the 104 patients treated with the staged repair, 58 achieved completion of anatomic repair. The 10-year mortality was 16.5%. In the patients with complete repair, the median right-to-left ventricle pressure ratio was 0.5. The overall surgical reoperation rate was 17%, and 15.5% of patients required postoperative interventional cardiac catheterization. In the multivariate analysis, the number of collateral vessels incorporated in the repair was found to be an independent risk factor for postoperative mortality and an elevated right-to-left ventricle pressure ratio after complete repair.
The staged repair can be successfully used to treat patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. This method yields a relatively low mortality with good functional results.
确定用于治疗室间隔缺损合并主-肺动脉侧支动脉的肺动脉闭锁患儿的早期和中期治疗结果。
我们回顾了104例患有这种复杂病变的患者的回顾性病例系列。信息来自病历和转诊医生。
在接受分期修复治疗的104例患者中，58例完成了解剖修复。10年死亡率为16.5%。在完全修复的患者中，右心室与左心室压力比的中位数为0.5。总体手术再手术率为17%，15.5%的患者术后需要进行心脏介入导管检查。在多变量分析中，修复中纳入的侧支血管数量被发现是术后死亡率和完全修复后右心室与左心室压力比升高的独立危险因素。
分期修复可成功用于治疗室间隔缺损合并主-肺动脉侧支动脉的肺动脉闭锁患者。该方法死亡率相对较低，功能结果良好。
