Scott W A, Rocchini A P, Bove E L, Behrendt D M, Beekman R H, Dick M, Serwer G, Snider R, Rosenthal A
Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor.
J Thorac Cardiovasc Surg. 1988 Oct;96(4):564-8.
Twenty-one patients undergoing repair of interrupted aortic arch between December of 1979 and January of 1987 were reviewed to determine the cause(s) of late morbidity and mortality. Ten underwent staged repair, and 11 had complete repair including all coexisting defects at the initial operation. Sixty-two percent are alive and clinically well 6 months to 6 years after the initial operation. Among the five patients who died late postoperatively, four had severe left ventricular outflow tract obstruction. Two other patients have had surgical relief of severe subaortic stenosis. In addition, significant recurrent or residual coarctation was found in four patients; it was relieved by balloon angioplasty in two patients, and two had surgical repair. None of the most recent seven patients, however, have had a residual ascending-descending aortic gradient. Careful follow-up for the detection of previously masked or newly developed left ventricular outflow tract obstruction is imperative and may be lifesaving.
对1979年12月至1987年1月期间接受主动脉弓中断修复术的21例患者进行了回顾，以确定晚期发病和死亡的原因。10例患者接受了分期修复，11例患者在初次手术时进行了包括所有并存缺陷的完全修复。62%的患者在初次手术后6个月至6年存活且临床状况良好。在术后晚期死亡的5例患者中，4例有严重的左心室流出道梗阻。另外2例患者接受了严重主动脉瓣下狭窄的手术缓解。此外，4例患者发现有明显的复发性或残余缩窄；2例患者通过球囊血管成形术缓解，2例患者接受了手术修复。然而，最近的7例患者中没有一例存在升主动脉-降主动脉残余压差。必须仔细随访以检测先前隐匿或新出现的左心室流出道梗阻，这可能挽救生命。
