Alonso J, Núñez P, Pérez de León J, Sánchez P A, Villagrá F, Gómez R, López Checa S, Vellibre D, Brito J M
Servicio de Cirugía Cardíaca Pediátrica, Hospital Ramón y Cajal, Madrid.
Rev Esp Cardiol. 1990 Jun-Jul;43(6):377-80.
Nine patients with complete atrioventricular canal and tetralogy of Fallot underwent intracardiac repair of both anomalies between 1982 and 1989. The ages of the patients ranged from 6 months to 7 years. Six of the 9 had one or more previous systemic-pulmonary artery shunts. Two-dimensional echocardiography showed diagnostic characteristics of both malformations in all patients. The diagnosis was confirmed by cardiac catheterization and cineangiography. The ventricular septal defect was repaired by a combined right atrial and ventricular approach in every patient. Outflow tract reconstruction was performed with the use of a transannular patch (4), infundibular patch (4), and a valved conduit (1). There were no hospital deaths. Meningitis was responsible for the death of a patient 2 years after repair. We recommend early palliation, complete repair in those older than 4 or 5 years, surgical technique depending on the anatomical findings, combined atrial and ventricular approach, 2 separate patches to close the ventricular septal defect in required cases, adjusted correction of the right ventricular outflow tract, and careful postoperative care.
1982年至1989年间，9例完全性房室通道合并法洛四联症患者接受了两种畸形的心脏内修复手术。患者年龄从6个月至7岁不等。9例患者中有6例曾接受过一次或多次体肺分流术。二维超声心动图显示所有患者均具有两种畸形的诊断特征。心脏导管检查和心血管造影术证实了诊断。每位患者均通过右心房和心室联合入路修复室间隔缺损。采用跨环补片（4例）、漏斗部补片（4例）和带瓣管道（1例）进行流出道重建。无住院死亡病例。一名患者在修复术后2年因脑膜炎死亡。我们建议早期姑息治疗，4或5岁以上患者进行完全修复，手术技术取决于解剖学发现，采用心房和心室联合入路，必要时用2个单独的补片关闭室间隔缺损，调整右心室流出道矫正，以及术后精心护理。
