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[新生儿及3岁以下婴幼儿主动脉缩窄的无导管介入手术]

[Surgery without catheterization of aortic coarctation in newborn infants and infants under 3 years of age].

作者信息

Guy J M, Bozio A, Sassolas F, Champsaur G, Ninet J, Senellart F, André M, Normand J

机构信息

Hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon.

出版信息

Arch Mal Coeur Vaiss. 1991 May;84(5):665-8.

PMID:1898200
Abstract

A retrospective study of 150 children under 3 months of age who underwent repair of coarctation of the aorta in the same center (between 1972 and 1987) was undertaken to assess the problems posed by surgery without cardiac catheterisation or angiography. The patients were divided into two groups: Group A, comprising 104 children operated after invasive investigations, and Group B, comprising 46 children operated on Doppler echocardiographic data alone. The two populations were comparable and "hypoplastic aortic arch" type coarctation was present in over 60% of cases. However, there were more ventricular septal defects in Group B (67.5%) than in Group A (49%). There were no significant diagnostic errors in Group B (one case of interrupted aortic arch diagnosed at surgery). The 1 month survival was the same in the two groups (82%). The indications of pulmonary artery banding were less frequent in Group B although there were more ventricular septal defects in these patients. These results confirm the value of Doppler echocardiography in the context of urgent surgery of congenital heart disease.

摘要

对同一中心(1972年至1987年)150例3个月以下接受主动脉缩窄修复术的儿童进行了一项回顾性研究,以评估在未进行心导管检查或血管造影的情况下进行手术所带来的问题。患者分为两组:A组,包括104例在进行侵入性检查后接受手术的儿童;B组,包括46例仅根据多普勒超声心动图数据接受手术的儿童。这两组人群具有可比性,超过60%的病例存在“主动脉弓发育不良”型缩窄。然而,B组(67.5%)的室间隔缺损比A组(49%)更多。B组没有明显的诊断错误(1例在手术时诊断为主动脉弓中断)。两组的1个月生存率相同(82%)。尽管这些患者的室间隔缺损更多,但B组肺动脉环扎术的指征较少。这些结果证实了多普勒超声心动图在先天性心脏病急诊手术中的价值。

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