Burchill Luke J, Wald Rachel M, Harris Louise, Colman Jack M, Silversides Candice K
University of Toronto, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2011;14(1):92-7. doi: 10.1053/j.pcsu.2011.01.016.
There is a growing population of young adults with tetralogy of Fallot. Although surgical approaches have evolved, many adults with repaired tetralogy of Fallot have been left with residual pulmonary regurgitation. Pulmonary regurgitation is an important contributor to a number of late complications including exercise limitations, right heart failure, arrhythmia, and sudden death. Because bioprosthetic valves are used in this population, clinicians must weigh the beneficial effects of pulmonary valve replacement against the associated risks, including subsequent re-operation. In this review, we will appraise the evidence supporting pulmonary valve replacement in the adult with repaired tetralogy of Fallot, as well as the optimal timing and mode of intervention.
患有法洛四联症的年轻成年人数量在不断增加。尽管手术方法已经有所发展，但许多接受过法洛四联症修复手术的成年人仍存在残余肺动脉反流。肺动脉反流是导致许多晚期并发症的重要因素，包括运动受限、右心衰竭、心律失常和猝死。由于该人群使用生物瓣膜，临床医生必须权衡肺动脉瓣置换的益处与相关风险，包括后续再次手术的风险。在本综述中，我们将评估支持对成年法洛四联症修复患者进行肺动脉瓣置换的证据，以及最佳干预时机和方式。
