Jacobs Jeffrey Phillip, Jacobs Marshall Lewis, Mavroudis Constantine, Chai Paul Jubeong, Tchervenkov Christo I, Lacour-Gayet Francois G, Walters Hal, Quintessenza James Anthony
Congenital Heart Institute of Florida, All Children's Hospital and Children's Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida, Saint Petersburg and Tampa, FL, USA.
World J Pediatr Congenit Heart Surg. 2010 Apr;1(1):68-77. doi: 10.1177/2150135110361504.
During the 4-year time interval of 2005 through 2008, the Society of Thoracic Surgeons Congenital Heart Surgery Database documented data about 2882 operations to repair atrioventricular (AV) canal defects: partial, 623 (21.5%); intermediate, 342 (11.8%);. complete, 1917 (66.3%). Mean age at complete repair (years) was as follows: partial, 6.1; intermediate, 2.9; complete, 0.6. Median age at complete repair (years) was as follows: partial, 2.6; intermediate, 0.9; complete, 0.4. Down syndrome was present in 1767 patients (61.1%). Debanding of the pulmonary artery was rarely performed: partial, 1 (0.2%); intermediate, 0 (0.0%); complete, 66 (3.4%). Deep hypothermic circulatory arrest was rarely used: partial, 6 (1.0%); intermediate, 5 (1.5%); complete, 52 (2.7%). Discharge mortality was low: partial, 2 (0.3%); intermediate, 3 (0.9%); complete, 38 (2.0%). Atrioventricular block requiring permanent pacemaker occurred but was uncommon: partial, 6 (1.0%); intermediate, 2 (0.6%); complete, 29 (1.5%). Unplanned reoperation prior to hospital discharge occurred in 3.9% of complete AV canal repairs. The sternum was left open in 3.0% of complete AV canal repairs. Postoperative cardiac arrest occurred in 1.9% of complete AV canal repairs. Mean postoperative length of stay (days) was as follows: partial, 5.2; intermediate, 7; complete, 13.1. Median postoperative length of stay (days) was as follows: partial, 4; intermediate, 4; complete, 7. This review of data from the Society of Thoracic Surgeons Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that 98% to 99% of patients survive complete repair of AV canal and 96% to 97% survive complete repair of AV canal with no major complications.
在2005年至2008年的4年时间间隔内，胸外科医师协会先天性心脏病手术数据库记录了2882例房室管缺损修复手术的数据：部分型，623例（21.5%）；中间型，342例（11.8%）；完全型，1917例（66.3%）。完全修复时的平均年龄（岁）如下：部分型，6.1岁；中间型，2.9岁；完全型，0.6岁。完全修复时的中位年龄（岁）如下：部分型，2.6岁；中间型，0.9岁；完全型，0.4岁。1767例患者（61.1%）患有唐氏综合征。肺动脉解带术很少施行：部分型，1例（0.2%）；中间型，0例（0.0%）；完全型，66例（3.4%）。深低温停循环很少使用：部分型，6例（1.0%）；中间型，5例（1.5%）；完全型，52例（2.7%）。出院死亡率较低：部分型，2例（0.3%）；中间型，3例（0.9%）；完全型，38例（2.0%）。需要永久起搏器的房室传导阻滞虽有发生但并不常见：部分型，6例（1.0%）；中间型，2例（0.6%）；完全型，29例（1.5%）。完全性房室管修复手术中有3.9%的患者在出院前进行了非计划性再次手术。完全性房室管修复手术中有3.0%的患者胸骨未闭合。完全性房室管修复手术中有1.9%的患者术后发生心脏骤停。术后平均住院时间（天）如下：部分型，5.2天；中间型，7天；完全型，13.1天。术后中位住院时间（天）如下：部分型，4天；中间型，4天；完全型，7天。对胸外科医师协会先天性心脏病手术数据库数据的此次回顾，为手术方式和结果模式提供了独特的记录。通过此次回顾，我们了解到98%至99%的患者在完全修复房室管后存活，96%至97%的患者在完全修复房室管且无重大并发症的情况下存活。
