Schmaltz A A, Schaible T, Apitz J
Abteilung für pädiatrische Kardiologie, Universitäts-Kinderklinik Tübingen.
Monatsschr Kinderheilkd. 1989 Mar;137(3):144-50.
In the years 1972-1983, 1131 infants below one year of age have been investigated by means of heart catheterization and angiography, some only by echocardiography,--if necessary--operated and followed for at least one year. Ventricular septal defect was the most frequent congenital heart defect (16.6%), followed by transposition of the great arteries (12.1%), AV-canal (9.1%) and patent ductus arteriosus (8.1%). 58.3% of all patients had more than one lesion, 27.6% had critical lesions, which caused symptoms and had to be cured during the first month of life. 63.3% of patients with critical lesions were male. Clinical diagnosis could be improved considerably by means of echocardiography: in contrast to the years 1972-1974, where only in 49% of patients a clinical diagnosis was known before heart catheterization, this was the case in 73.1% in the years 1981-1983. Additional malformations of other organs were found in 28.6%, 19.9% had a birthweight below 2.5 kg. Concerning the various diagnoses, there were no regional or seasonal differences. The general rate of heart defects is said to be 0.8%, familiarity was 4.5%. Frequency of operations was 64.4%, mortality 37.4%, which could be improved by 10% in comparison of the beginning to the end of the time of observation.
在1972年至1983年期间,对1131名一岁以下婴儿进行了心导管检查和血管造影,部分仅进行了超声心动图检查(必要时),并进行了手术,术后随访至少一年。室间隔缺损是最常见的先天性心脏缺陷(16.6%),其次是大动脉转位(12.1%)、房室通道(9.1%)和动脉导管未闭(8.1%)。所有患者中有58.3%存在不止一种病变,27.6%有严重病变,这些病变导致症状,必须在出生后第一个月内治愈。有严重病变的患者中63.3%为男性。超声心动图可显著改善临床诊断:与1972年至1974年相比,当时在心导管检查前仅49%的患者有临床诊断,而在1981年至1983年这一比例为73.1%。在28.6%的患者中发现了其他器官的额外畸形,19.9%的患者出生体重低于2.5千克。关于各种诊断,不存在地区或季节差异。一般心脏缺陷发生率据说为0.8%,家族发病率为4.5%。手术频率为64.4%,死亡率为37.4%,与观察期开始至结束相比,死亡率可降低10%。