Humes R A, Driscoll D J, Mair D D, Danielson G K, McGoon D C
Section of Pediatric Cardiology, Mayo Clinic, Rochester, Minn. 55905.
J Thorac Cardiovasc Surg. 1988 Sep;96(3):364-7.
A palliative operation to create intraatrial transposition of venous return without concomitant closure of an associated ventricular septal defect (palliative Mustard or Senning operation) has been used primarily for patients with a combination of transposition of the great arteries, ventricular septal defect, and pulmonary vascular obstructive disease. We evaluated the results in all 15 patients (median age 13 years) who had this procedure at the Mayo Clinic between 1973 and 1979. There were two (13%) operative deaths. One patient was lost to long-term follow-up. Of the 12 operative survivors for whom follow-up data were available, 11 reported subjective improvement in exercise tolerance and activity level. There were seven late deaths: six from cardiovascular problems and one from an accident. There are five survivors currently alive (average 10.8 years after operation). Patients who survived the operation for more than 5 years had a significantly (p less than 0.05) lower pulmonary resistance preoperatively than those who survived less than 5 years. The hemoglobin level decreased from 21.1 gm/dl before operation to 18.4 gm/dl, and arterial saturation was increased from 64% to 85% at an average of 9 years after operation. We conclude that this operation produces subjective improvement and lessens hypoxemia and polycythemia. In some patients, palliation may be achieved for 10 years or longer.
一种姑息性手术，即创建心房内静脉回流转位但不伴相关室间隔缺损闭合（姑息性Mustard或Senning手术），主要用于患有大动脉转位、室间隔缺损和肺血管阻塞性疾病组合的患者。我们评估了1973年至1979年间在梅奥诊所接受该手术的所有15例患者（中位年龄13岁）的结果。有2例（13%）手术死亡。1例患者失访。在有随访数据的12例手术幸存者中，11例报告运动耐量和活动水平有主观改善。有7例晚期死亡：6例死于心血管问题，1例死于意外事故。目前有5例幸存者在世（术后平均10.8年）。术后存活超过5年的患者术前肺阻力显著低于存活不足5年的患者（p<0.05）。血红蛋白水平从术前的21.1 g/dl降至术后平均9年时的18.4 g/dl，动脉血氧饱和度从64%升至85%。我们得出结论，该手术可带来主观改善，并减轻低氧血症和红细胞增多症。在一些患者中，姑息治疗可能持续10年或更长时间。
