Zannini Lucio, Borini Italo
Division of Pediatric Cardiac Surgery, IRCCS Giannina Gaslini, Genoa, Italy.
J Cardiovasc Med (Hagerstown). 2007 Jan;8(1):3-6. doi: 10.2459/01.JCM.0000247427.44204.0d.
During the last 20 years, pediatric cardiac surgery has been characterized by important changes, with reductions in surgical mortality and the achievement of complete repair at an earlier age, thus avoiding multiple procedures and strongly ameliorating the global outcome of these patients. In this review, we describe the actual trends in the surgical treatment of cardiac malformations. We analyze two groups of patients: in the first group (septal defects, tetralogy of Fallot, transposition of the great arteries, aortic stenosis and coarctation) the indications are well established and the goal is represented by a lessening of the surgical trauma and post-operative morbidity, with stable results in the follow-up. In the second group (univentricular heart, pulmonary atresia and intact ventricular septum, double discordance, conduit, hypoplastic left heart syndrome), the lesions are still considered complex and submitted to ongoing experimental and clinical research, in order to improve the post-surgical history of these diseases.
在过去20年里，小儿心脏外科手术发生了重大变化，手术死亡率降低，且能在更小年龄实现完全修复，从而避免了多次手术，并显著改善了这些患者的总体预后。在本综述中，我们描述了心脏畸形外科治疗的实际趋势。我们分析了两组患者：第一组（房间隔缺损、法洛四联症、大动脉转位、主动脉狭窄和主动脉缩窄）的手术指征已明确确立，目标是减少手术创伤和术后发病率，随访结果稳定。第二组（单心室、肺动脉闭锁伴完整室间隔、双不协调、人工管道、左心发育不全综合征）的病变仍被视为复杂病变，正在进行实验和临床研究，以改善这些疾病的术后情况。
