Ciaravella J M, McGoon D C, Danielson G K, Wallace R B, Mair D D, Ilstrup D M
J Thorac Cardiovasc Surg. 1979 Dec;78(6):920-30.
A review is made of all Mayo Clinic cases wherein 468 patients have received 516 extracardiac conduits in the repair of congenital heart defects. All patients had complex defects, which are classified in 10 basic diagnostic categories. The early mortality rate (which ranged from 4% to 49%, according to diagnostic group) averaged 25%, improving with experience. The postoperative complication rate was 70%. In 1% of operations, compression of the conduit was encountered at chest closure. The conduits placed in 333 patients contained a porcine valve. The conduit diameter averaged 22 mm. At completion of the operation, the mean gradient across the conduit was 22.8 mm Hg. At late study this mean gradient remained at 26 mm Hg in patients who had received the currently employed porcine-valved conduit. The average ratio of intraoperative postrepair ventricular (RV/LV) systolic pressures was 0.68. It was lower among the group who were to survive but was not ov prognostic value in individual cases. Among patients who survived the postoperative period, the late mortality rate (based on a mean of 3.6 years' follow-up) averaged 3.5% per year. Of the long-term survivors, 18% have required reoperation, primarily for replacement of calcified aortic homograft conduits used in the earlier part of the experience. Only 0.8% of porcine-valved conduits have required reoperation. Unrestricted life-styles were possible for 90% of survivors.
对梅奥诊所的所有病例进行了回顾，其中468例患者在先天性心脏缺陷修复中接受了516根心外管道。所有患者均有复杂缺陷，分为10个基本诊断类别。早期死亡率（根据诊断组不同，从4%到49%不等）平均为25%，随着经验的积累有所改善。术后并发症发生率为70%。在1%的手术中，关闭胸腔时遇到管道受压情况。333例患者植入的管道含有猪瓣膜。管道直径平均为22毫米。手术结束时，管道两端的平均压差为22.8毫米汞柱。在后期研究中，接受当前使用的带猪瓣膜管道的患者，该平均压差仍为26毫米汞柱。术中修复后心室（右心室/左心室）收缩压的平均比值为0.68。在存活患者组中该比值较低，但对个别病例无预后价值。在术后存活的患者中，后期死亡率（基于平均3.6年的随访）平均每年为3.5%。在长期存活者中，18%需要再次手术，主要是为了更换早期经验中使用的钙化主动脉同种异体移植管道。只有0.8%的带猪瓣膜管道需要再次手术。90%的存活者能够拥有不受限制的生活方式。
