Hisatomi K, Isomura T, Kosuga K, Sato T, Nishimi M, Mizoguchi T, Ishii H, Aoyagi S, Ohishi K, Kato H
Department of Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1991;38(3):149-57. doi: 10.2739/kurumemedj.38.149.
A follow-up study was conducted of 166 patients who had survived for more than 10 years after total correction of tetralogy of Fallot. The total number of patients in NYHA class I was 141 (85%); the other 25 patients had been medically treated or had followed a prudent life style. The factors which caused postoperative symptoms were residual lesions and ventricular arrhythmia. Ultrasonic echocardiography showed that among 72 patients with transannular patch, 68 (95%) showed moderate or severe pulmonary incompetence. There was a correlation of gamma = 0.43 between the severity of pulmonary incompetence and cardiothoracic ratio in the 48 patients without any residual lesions, while two cases with severe pulmonary incompetence showed obvious right ventricular failure. Ambulatory ECG monitoring was employed to study 53 patients. As a result, 21 patients were found to present solitary moderate or severe pulmonary incompetence, while premature ventricular contraction of Lown's grade 4A was seen in nine patients (42.9%). In conclusion, it is considered essential to carefully follow up patients after intracardiac repair of tetralogy of Fallot, especially those with severe pulmonary incompetence.
对166例法洛四联症根治术后存活超过10年的患者进行了一项随访研究。纽约心脏协会（NYHA）心功能I级的患者总数为141例（85%）；其他25例患者接受了药物治疗或保持了谨慎的生活方式。导致术后症状的因素是残余病变和室性心律失常。超声心动图显示，在72例采用跨瓣环补片的患者中，68例（95%）显示中度或重度肺动脉瓣关闭不全。在48例无任何残余病变的患者中，肺动脉瓣关闭不全的严重程度与心胸比率之间的相关系数γ=0.43，而2例重度肺动脉瓣关闭不全的患者出现明显的右心室衰竭。采用动态心电图监测对53例患者进行研究。结果，发现21例患者存在孤立性中度或重度肺动脉瓣关闭不全，9例患者（42.9%）出现洛恩（Lown）4A级室性早搏。总之，法洛四联症心内修复术后对患者进行仔细随访被认为是至关重要的，尤其是那些患有重度肺动脉瓣关闭不全的患者。
