Bove E L
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48105.
Ann Thorac Surg. 1991 Sep;52(3):701-4; discussion 704-7. doi: 10.1016/0003-4975(91)90981-u.
The surgical treatment of infants born with hypoplastic left heart syndrome has received considerable attention in recent years. Although this lesion was previously considered uniformly fatal, dramatic successes have been achieved with the use of staged reconstructive and replacement therapies. However, both surgical options have benefits and limitations, and neither has demonstrated clear superiority over the other. As survival for first-stage reconstruction by the Norwood procedure has improved, a greater number of patients are potential candidates for the Fontan operation, but not all will be suitable at an acceptable risk. These patients may be treated by cardiac transplantation. The results of a treatment protocol for 90 patients with classic hypoplastic left heart syndrome or its variants at The University of Michigan are reported, with particular attention given to those patients surviving initial palliation but judged to be unsuitable for a subsequent Fontan procedure.
近年来，患有左心发育不全综合征的婴儿的外科治疗受到了相当多的关注。尽管这种病变以前被认为是一致致命的，但通过分期重建和替代疗法已经取得了显著成功。然而，这两种手术选择都有其优点和局限性，且均未显示出明显优于对方。随着诺伍德手术一期重建的生存率提高，越来越多的患者有可能接受Fontan手术，但并非所有患者都能在可接受的风险下适合该手术。这些患者可能需要接受心脏移植。本文报告了密歇根大学针对90例经典左心发育不全综合征或其变体患者的治疗方案结果，特别关注那些在初始姑息治疗后存活但被判定不适合后续Fontan手术的患者。
