Karamlou Tara, McCrindle Brian W, Williams William G
Division of Cardiovascular Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
Nat Clin Pract Cardiovasc Med. 2006 Nov;3(11):611-22. doi: 10.1038/ncpcardio0682.
Biventricular correction of tetralogy of Fallot was devised more than 50 years ago. Current short-term outcomes are excellent. The potential for late complications is, however, an important concern for the growing number of postrepair survivors. Progressive pulmonary valve regurgitation leading to right heart failure and arrhythmia are centrally important problems faced by these patients. New techniques are, however, likely to change the future outcomes for postrepair survivors. These techniques include percutaneous valve replacement, arrhythmia ablation surgery, and strategies that emphasize preservation of the pulmonary valve even at the cost of leaving some residual valvular stenosis. The objectives of this Review are to outline the major complications that arise late after repair of tetralogy of Fallot, to describe the surgical approaches that have been developed to avoid and manage arising complications, and to briefly explore how novel treatment paradigms could change the future long-term outlook for patients following tetralogy repair.
法洛四联症的双心室矫正术在50多年前就已设计出来。目前的短期疗效极佳。然而，随着修复术后存活患者数量的增加，远期并发症的可能性成为一个重要问题。导致右心衰竭和心律失常的进行性肺动脉瓣反流是这些患者面临的核心重要问题。不过，新技术可能会改变修复术后存活者的未来结局。这些技术包括经皮瓣膜置换术、心律失常消融手术，以及即使以遗留一些残余瓣膜狭窄为代价也要强调保留肺动脉瓣的策略。本综述的目的是概述法洛四联症修复术后晚期出现的主要并发症，描述为避免和处理出现的并发症而开发的手术方法，并简要探讨新型治疗模式如何改变法洛四联症修复术后患者的未来长期前景。
