Hartyánszky István, Temesvári András, Szatmári András, Szudi László, Prodán Zsolt, Mihályi Sándor, Lipptai Csilla
Gottsegen György Országos Kardiológiai Intézet, Budapest.
Orv Hetil. 2004 Nov 14;145(46):2335-7.
A 36 year old male with tetralogy of Fallot and pulmonary atresia was corrected successfully. Previous palliative operation (Cooley shunt) was performed 35 years before. He was in NYHA functional class III. because of chronic hypoxia, polyglobulia, cerebral accident, pulmonary complications, myocardial (ventricular) dysfunction and syncopes. After an uneventful surgical reconstruction, the postoperative period was complicated with haemostasis complication and pulmonary distress syndrome. He left the hospital in NYHA functional class I on the 20th postoperative day in very good condition.
Complete cardiac recovery will be possible after successful surgically reconstruction of tetralogy of Fallot and pulmonary atresia even in adulthood. The reconsideration of operability of such cases is recommended. As the patient may have different extracardiac complications in every case new complete reconsideration is necessary for the indication of surgical reconstruction.
一名36岁患有法洛四联症和肺动脉闭锁的男性患者成功接受了矫正手术。35年前曾进行过姑息性手术(库利分流术)。他处于纽约心脏协会(NYHA)心功能Ⅲ级,原因是慢性缺氧、红细胞增多症、脑卒、肺部并发症、心肌(心室)功能障碍和晕厥。在一次顺利的手术重建后,术后出现了止血并发症和肺窘迫综合征。术后第20天,他以非常良好的状态出院,心功能为NYHAⅠ级。
即使在成年期,法洛四联症和肺动脉闭锁成功进行手术重建后也有可能实现完全心脏恢复。建议重新考虑此类病例的可手术性。由于每个患者可能有不同的心外并发症,因此对于手术重建的指征需要重新进行全面考虑。