法洛四联症修复术后成人肺动脉瓣置换的最佳时机。
Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair.
作者信息
Therrien Judith, Provost Yves, Merchant Naeem, Williams William, Colman Jack, Webb Gary
机构信息
Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada.
出版信息
Am J Cardiol. 2005 Mar 15;95(6):779-82. doi: 10.1016/j.amjcard.2004.11.037.
The timing of pulmonary valve replacement in adult patients with repaired tetralogy of Fallot remains controversial. A magnetic resonance imaging study in 17 adult patients with repaired tetralogy of Fallot reveals a statistically significant decrease in right ventricular (RV) volume (RV end-diastolic volume 163 +/- 34 to 107 +/- 26 ml/m2, p <0.001; RV end-systolic volume 109 +/- 27 to 69 +/- 22 ml/m2, p <0.001) at a mean follow-up of 21 months after pulmonary valve replacement; whereas RV systolic function remained unchanged (mean RV ejection fraction 32 +/- 7% to 34 +/- 10%, p = 0.12). In no patients with a RV end-diastolic volume >170 ml/m2 or a RV end-systolic volume >85 ml/m2 before pulmonary valve replacement were RV volumes "normalized" after surgery.
法洛四联症修复术后成年患者肺动脉瓣置换的时机仍存在争议。一项针对17例法洛四联症修复术后成年患者的磁共振成像研究显示，肺动脉瓣置换术后平均随访21个月时，右心室（RV）容积有统计学意义的显著下降（RV舒张末期容积从163±34降至107±26 ml/m²，p<0.001；RV收缩末期容积从109±27降至69±22 ml/m²，p<0.001）；而RV收缩功能保持不变（平均RV射血分数从32±7%至34±10%，p = 0.12）。肺动脉瓣置换术前RV舒张末期容积>170 ml/m²或RV收缩末期容积>85 ml/m²的患者，术后RV容积均未“恢复正常”。
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