Okabayashi H, Ban T
Department of Cardiovascular Surgery, Faculty of Medicine, Kyoto University.
Kyobu Geka. 1990 Jul;43(8):653-9.
One hundred sixty-two patients underwent total correction of tetralogy of Fallot from 1962 to 1979. 130 of these were hospital survivors. We studied the current status of the hospital survivors by questionnaires which were sent to 93 patients. An excellent long-term result was maintained by 87.3% of the 63 hospital survivors who answered to the questionnaires. Although there was a trend toward a higher incidence of symptoms in patients with a higher late postoperative RV/LV pressure ratio and in patients with older age at repair, it did not reach statistical significance. Six patients in this series have undergone reoperation. The most common cardiac problem which required reoperation was residual of the VSD. There was one late sudden death postoperatively. The RV/LV pressure ratio of the patient was 0.7 and the electrocardiogram at rest showed no abnormality except CRBBB. The ventricular dysarrhythmia was supposed as the cause of sudden death. The patients who underwent total correction of tetralogy of Fallot should be followed up by exercise ECG or 24 hours electrocardiographic monitoring.
1962年至1979年间,162例患者接受了法洛四联症的根治手术。其中130例为住院幸存者。我们通过向93例患者发送问卷来研究这些住院幸存者的现状。在回复问卷的63例住院幸存者中,87.3%保持了良好的长期结果。尽管术后晚期右心室/左心室压力比更高的患者以及修复时年龄较大的患者出现症状的发生率有升高趋势,但未达到统计学意义。本系列中有6例患者接受了再次手术。需要再次手术的最常见心脏问题是室间隔缺损残余。术后有1例晚期猝死。该患者的右心室/左心室压力比为0.7,静息心电图除完全性右束支传导阻滞外无异常。推测室性心律失常为猝死原因。接受法洛四联症根治手术的患者应通过运动心电图或24小时心电图监测进行随访。