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6个月以下婴儿法洛四联症的完全修复。关于25例病例

[Complete repair of tetralogy of Fallot in infants under the age of 6 months. Apropos of 25 cases].

作者信息

Guirgis N H, Losay J, Serraf A, Ouaknine R, Chambran P, Lacour-Gayet F, Bruniaux J, Binet J P, Planché C

机构信息

Centre chirurgical Marie-Lannelongue, Le Plessis-Robinson.

出版信息

Arch Mal Coeur Vaiss. 1991 May;84(5):679-83.

PMID:1898202
Abstract

Between January 1982 and October 1988, 25 infants with Tetralogy of Fallot underwent total correction, total primary repair was carried out in 22 cases; 3 underwent correction after a palliative anastomosis. The average age was 3.7 +/- 1.6 months; the average weight was 5.06 +/- 1.41 kg and average body surface area was 0.30 +/- 0.06 m2. Nineteen patients had a regular anatomic form and 6 had an irregular form of the condition. The hospital mortality was 8% (2 cases): the mortality was nil in the regular anatomic form but 33% in the irregular anatomic forms. Twenty-one patients have been followed up for an average of 50.8 +/- 19.2 months. There were no late deaths; two patients were reoperated for a residual pulmonary stenosis; 19 patients are well and asymptomatic. Doppler echocardiography shows a residual pressure gradient between the right ventricule and pulmonary artery of 17.8 +/- 22.7 mmHg associated with a grade 1-2/4 pulmonary regurgitation. There are no residual ventricular septal defects or cases of atrioventricular block requiring permanent pacing.

摘要

1982年1月至1988年10月期间,25例法洛四联症婴儿接受了根治手术,22例进行了一期完全修复;3例在姑息性吻合术后进行了矫治。平均年龄为3.7±1.6个月;平均体重为5.06±1.41千克,平均体表面积为0.30±0.06平方米。19例患者为正常解剖形态,6例为异常解剖形态。医院死亡率为8%(2例):正常解剖形态者无死亡,异常解剖形态者死亡率为33%。21例患者接受了平均50.8±19.2个月的随访。无晚期死亡病例;2例患者因残留肺动脉狭窄接受了再次手术;19例患者情况良好且无症状。多普勒超声心动图显示右心室与肺动脉之间的残余压力阶差为17.8±22.7毫米汞柱,伴有1-2/4级肺动脉反流。无残余室间隔缺损或需要永久起搏的房室传导阻滞病例。

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