Driscoll D J
Division of Pediatric Cardiology, Mayo Clinic, 200 1st Street S.W., Rochester, MN 55905, USA.
Pediatr Cardiol. 2007 Nov-Dec;28(6):438-42. doi: 10.1007/s00246-007-9003-4.
Modifications of the Fontan operation can afford excellent palliation for many patients with a variety of forms of single ventricle. In properly selected patients who are good candidates, early and late survival can be as high as 95-97%. However, mortality is considerably higher for patients with risk factors for poor outcome. For high-risk patients, inclusion of a fenestration may reduce morbidity and mortality. Important long-term undesirable events include the ongoing risk of death, arrhythmias, protein-losing enteropathy, and cardiac failure. The key to excellent long-term outcome is proper selection of patients for the operation.
改良Fontan手术可为多种类型单心室的许多患者提供良好的姑息治疗。在经过恰当选择、适合手术的患者中,早期和晚期生存率可达95% - 97%。然而,存在预后不良风险因素的患者死亡率要高得多。对于高危患者,施行开窗术可能会降低发病率和死亡率。重要的长期不良事件包括持续存在的死亡风险、心律失常、蛋白丢失性肠病和心力衰竭。实现良好长期预后的关键在于恰当选择手术患者。