Dhasmana J P, Stark J, de Leval M, Macartney F J, Rees P G, Taylor J F
J Am Coll Cardiol. 1985 Nov;6(5):1138-41. doi: 10.1016/s0735-1097(85)80321-1.
A long-term follow-up study after 41 palliative Mustard operations for transposition of the great arteries and pulmonary vascular obstructive disease is presented. The operations were performed from 1973 to 1980. Mean pulmonary arteriolar resistance was 13.96 +/- 6.7 Um2. A ventricular septal defect was not closed in 34 patients; in 7 it was created at operation. There were three hospital and two late deaths. Survivors were followed up for 3 to 10 years (mean 76.7 +/- 22.8 months). Before operation 4 children were in New York Heart Association functional class IV and 33 were in class III. Mean hemoglobin concentration was 19.43 +/- 3.14 g/dl and arterial oxygen saturation was 63.44 +/- 11.29%. After operation 18 patients were in functional class I, 17 in class II and only 1 in class III. Hemoglobin level decreased to 14.19 +/- 2.3 g/dl and arterial oxygen saturation improved to 89.12 +/- 7.25%. Cardiac catheterization in 21 survivors confirmed no change in pulmonary artery pressure and resistance. Effective pulmonary blood flow improved from 1.39 +/- 0.39 before to 2.6 +/- 0.78 liters/min per m2 after operation. The palliative Mustard operation carries a low risk and provides excellent symptomatic improvement up to 10 years in patients with transposition of the great arteries and pulmonary vascular disease.
本文介绍了41例姑息性Mustard手术治疗大动脉转位和肺血管阻塞性疾病后的长期随访研究。这些手术于1973年至1980年进行。平均肺小动脉阻力为13.96±6.7 Um2。34例患者未闭合室间隔缺损；7例在手术时制造了室间隔缺损。有3例院内死亡和2例晚期死亡。幸存者随访了3至10年（平均76.7±22.8个月）。术前，4名儿童为纽约心脏协会功能IV级，33名儿童为III级。平均血红蛋白浓度为19.43±3.14 g/dl，动脉血氧饱和度为63.44±11.29%。术后，18例患者为功能I级，17例为II级，仅1例为III级。血红蛋白水平降至14.19±2.3 g/dl，动脉血氧饱和度提高至89.12±7.25%。21例幸存者的心脏导管检查证实肺动脉压力和阻力无变化。有效肺血流量从术前的1.39±0.39升/分钟每平方米提高到术后的2.6±0.78升/分钟每平方米。姑息性Mustard手术风险低，能为大动脉转位和肺血管疾病患者提供长达10年的显著症状改善。
