Nagashima Mitsugi, Tomino Tetsuo, Satoh Harumitsu, Nakata Tatsuhiro, Ohtani Takashi, Saito Hiroyuki
Department of Cardiovascular Surgery, Ehime Prefectural Central Hospital, Matsuyama city, Ehime, Japan.
Asian Cardiovasc Thorac Ann. 2005 Jun;13(2):127-30. doi: 10.1177/021849230501300206.
Patients with double-chambered right ventricle presenting with symptoms in adulthood are rare. From 1990 to 2004, 4 adults and 9 children with double-chambered right ventricle underwent surgical correction. The surgical results and clinical data of the adults were compared with those of the pediatric patients. All adult patients had dyspnea on exertion, 3 children showed growth delay but the others were asymptomatic. The mean age at operation was 44.5 +/- 6.3 years in adults and 5.2 +/- 1.9 years in children. The mean pressure gradient between the anatomically lower right ventricle and the pulmonary artery was significantly higher in adults than in children (91.8 +/- 14.1 vs. 42.2 +/- 5.9 mm Hg). The pulmonary-to-systemic flow ratio in adults was significantly lower than in pediatric patients (1.2 +/- 0.2 vs. 1.8 +/- 0.3). All adults and 8 of the 9 children survived. There were no late deaths or re-operations, and all survivors were in New York Heart Association functional class I. Surgical correction of double-chambered right ventricle in adults gave satisfactory midterm results although right ventricular outflow tract obstruction and clinical symptoms were severe in these patients.
成年期出现症状的双腔右心室患者较为罕见。1990年至2004年，4例成年双腔右心室患者和9例儿童患者接受了手术矫正。将成年患者的手术结果和临床数据与儿科患者的进行比较。所有成年患者均有劳力性呼吸困难，3例儿童生长发育迟缓，其他儿童无症状。成年患者手术时的平均年龄为44.5±6.3岁，儿童为5.2±1.9岁。成年患者解剖学上较低的右心室与肺动脉之间的平均压力阶差显著高于儿童（91.8±14.1对42.2±5.9 mmHg）。成年患者的肺循环与体循环血流量之比显著低于儿科患者（1.2±0.2对1.8±0.3）。所有成年患者和9例儿童中的8例存活。无晚期死亡或再次手术情况，所有存活者纽约心脏协会心功能分级均为I级。尽管成年双腔右心室患者右心室流出道梗阻及临床症状严重，但手术矫正仍取得了满意的中期效果。
