Kuribayashi R, Sakurada T, Sekine S, Aida H, Goto Y, Seki K, Hayashi R, Sato M, Abe T
Department of Cardiovascular Surgery, Akita University School of Medicine.
Kyobu Geka. 1990 Oct;43(11):867-72.
Between April 1972 and March 1979, eighteen total correction for tetralogy of Fallot less than 2 years old were performed with a mortality rate of 11.1%. The valved patch made of autologous pericardium was utilized for right ventricular outflow reconstruction in 12 of 16 survivors. Late (from 10 to 17 postoperative year) results of the all survivors were studied on functional and clinical status, hemodynamics and cardiac functions, and also, were compared with that of the patients above 2 years of age. All of them were in NYHA class I with no physical exercise limitation. Chest X-ray showed nearly normal CTR of 51.7%. ECG showed complete or incomplete RBBB in 14 patients and LAD in 3 of them, whereas no ventricular arrhythmia. Cardiac catheterization and cineangiography revealed that they had quite satisfactory hemodynamics and cardiac functions despite their moderate pulmonary regurgitation. In comparison with the older patient group, this younger one had a tendency to take superior results in all parameters of cardiac functions and clinical status. These excellent long term results seem to come from their young and less degenerative myocardium at the time of surgery.
1972年4月至1979年3月期间,对18例年龄小于2岁的法洛四联症患者进行了全矫正手术,死亡率为11.1%。16名幸存者中有12名采用自体心包制成的带瓣补片进行右心室流出道重建。对所有幸存者的晚期(术后10至17年)功能和临床状况、血流动力学和心脏功能进行了研究,并与2岁以上患者进行了比较。所有患者均为纽约心脏协会(NYHA)I级,无体力活动受限。胸部X线显示心胸比率(CTR)接近正常,为51.7%。心电图显示14例患者有完全或不完全性右束支传导阻滞(RBBB),其中3例有左前分支阻滞(LAD),但无室性心律失常。心导管检查和心血管造影显示,尽管有中度肺反流,但他们的血流动力学和心脏功能相当令人满意。与年龄较大的患者组相比,较年轻的患者组在心脏功能和临床状况的所有参数方面往往有更好的结果。这些出色的长期结果似乎源于他们手术时年轻且退变较轻的心肌。