Schlick W, Pils P, Unger F, Schmid P, Mohl W, Frey M, Domanig E, Navrátil J
Thoraxchir Vask Chir. 1978 Apr;26(2):109-16. doi: 10.1055/s-0028-1096606.
55 of 59 patients with artial septal defect, who had been operated in adult age, were examined postoperatively. The mean time interval from the operation was 43,8 months. Two patients had died immediately after the operation; there were no late deaths. The majority of the reexamined subjects was free of symptoms, in no case was there congestive heart failure. Persistence of postoperative symptoms increased with increasing age at the time of operation, but only up to the fourth decade of life. In 26 cases hemodynamics were examined. Mean pulmonary arterial pressure was normal at rest and during a slight ergometric load. In 5 patients there was moderate pulmonary hypertension. In 8 subjects there was minimal, in one patient moderate increase of pulmonary vascular resistance. Heartsize in chest roentgenogramm was increased in about 25% of cases, in more than 50% the pulmonary vessels were accentuated. Irregularities of cardiac rhythm were not more frequent postoperatively, than they had been prior to surgery. However, surgery was followed by a marked decrease of right axis deviation and of EKG signs of right ventricular hypertrophy. Pulmonary function studies revealed a slight decrease of vital capacity and of maximal breathing capacity. These results are favourable compaired to medically treated groups of patients as described in the literature. It is concluded, that even in later adult age the atrial septal defect as a rule is an indication for surgery.
59例成年期接受手术治疗的房间隔缺损患者中,55例术后接受了检查。距手术的平均时间间隔为43.8个月。2例患者术后立即死亡;无晚期死亡病例。大多数复查对象无症状,无一例出现充血性心力衰竭。术后症状的持续存在随手术时年龄的增加而增加,但仅至生命的第四个十年。26例进行了血流动力学检查。静息和轻微运动负荷时平均肺动脉压正常。5例患者有中度肺动脉高压。8例受试者有轻度,1例患者有中度肺血管阻力增加。胸部X线片显示约25%的病例心脏增大,超过50%的病例肺血管增粗。术后心律失常的发生率并不比手术前更高。然而,手术后右轴偏移和右心室肥大的心电图征象明显减少。肺功能研究显示肺活量和最大呼吸量略有下降。与文献中描述的药物治疗组患者相比,这些结果是有利的。得出的结论是,即使在成年后期,房间隔缺损通常也是手术指征。