Watanabe T, Hojo Y, Smallhorn J F, Freedom R M
Division of Pediatrics, Nagoya National Hospital.
J Cardiol. 1991;21(4):993-1000.
Twenty-four patients with persistent truncus arteriosus who underwent total surgical correction at The Hospital for Sick Children in Toronto, Canada between October 1984 and December 1987 were investigated to determine whether the postoperative course is satisfactory even without performing replacement of the truncal valve. All patients but one were less than 6 months of age. There were 9 operative deaths with a mortality rate of 37%. The most significant incremental risk factor was age of less than 30 days at the time of surgery (p < 0.01). The operative mortality did not correlate with the degree of preoperative truncal valve regurgitation nor stenosis. Among 15 hospital survivors, 14 patients were followed by echocardiography within one week after surgery, 4 of whom were reexamined within 2 weeks. Four patients without truncal valve regurgitation and stenosis underwent successful surgery, however, mild regurgitation developed in one 2 weeks after surgery. Among 4 patients with solitary truncal valve regurgitation, 2 improved and the other 2 did not. Among 5 patients with truncal regurgitation and stenosis, 3 improved in both truncal valve regurgitation and stenosis, but improvement was observed in only stenosis in the other 2 patients. One patient with stenosis improved, but developed mild regurgitation 2 weeks later. After radical surgery, 8 of the 10 patients (80%) with regurgitation and/or stenosis showed improvement without performing replacement of the truncal valve.
对1984年10月至1987年12月期间在加拿大多伦多病童医院接受全手术矫正的24例持续性动脉干患者进行了调查，以确定即使不进行动脉干瓣膜置换，术后过程是否令人满意。除1例患者外，所有患者年龄均小于6个月。有9例手术死亡，死亡率为37%。最显著的增加风险因素是手术时年龄小于30天（p<0.01）。手术死亡率与术前动脉干瓣膜反流程度或狭窄程度无关。在15名住院幸存者中，14例患者在术后1周内接受了超声心动图检查，其中4例在2周内接受了复查。4例无动脉干瓣膜反流和狭窄的患者手术成功，但1例在术后2周出现轻度反流。在4例单纯动脉干瓣膜反流患者中，2例有所改善，另2例未改善。在5例动脉干反流和狭窄患者中，3例动脉干瓣膜反流和狭窄均有所改善，但另2例仅在狭窄方面有所改善。1例狭窄患者有所改善，但2周后出现轻度反流。根治性手术后，10例有反流和/或狭窄的患者中有8例（80%）在未进行动脉干瓣膜置换的情况下病情有所改善。
