Francois K, Tamim M, Bove T, De Groote K, De Wolf D, Matthys D, Suys B, Verhaaren H, Van Nooten G
Department of Congenital Cardiac Surgery, University Hospital Gent, Belgium.
Pediatr Cardiol. 2005 Jul-Aug;26(4):350-5. doi: 10.1007/s00246-005-8646-2.
In a retrospective study of 32 consecutive patients undergoing a total cavopulmonary connection (TCPC), we tried to determine if the trend for decreasing age at Fontan completion and reducing the intervals between the staged procedures during the past decade was associated with a change in morbidity and outcome. In 8 patients the Fontan circulation was completed in one stage and in 24 patients an intermediate step by hemi-Fontan or bidirectional cavopulmonary anastomosis was performed before Fontan completion. Mean age at TCPC and mean interval since the previous palliation have decreased significantly during the past decade. Although major complications were significantly reduced over time the occurrence and duration of postoperative pleural effusions were not. Decreasing age as well as intervals in staged Fontan palliation have beneficial influence on major complications and outcome, without significantly affecting the duration of pleural effusions at Fontan completion.
在一项对32例连续接受全腔静脉肺动脉连接术（TCPC）患者的回顾性研究中，我们试图确定在过去十年中，Fontan手术完成时年龄降低的趋势以及分期手术间隔时间缩短是否与发病率和结局的变化相关。8例患者Fontan循环一期完成，24例患者在Fontan手术完成前通过半Fontan或双向腔肺吻合术进行了中间步骤。在过去十年中，TCPC时的平均年龄以及自上次姑息治疗以来的平均间隔时间均显著降低。尽管随着时间推移主要并发症显著减少，但术后胸腔积液的发生率和持续时间并未降低。Fontan分期姑息治疗中年龄降低以及间隔时间缩短对主要并发症和结局有有益影响，而对Fontan手术完成时胸腔积液的持续时间无显著影响。
