Blackstone E H, Shimazaki Y, Maehara T, Kirklin J W, Bargeron L M
Department of Surgery, University of Alabama, Birmingham School of Medicine and Medical Center 35294.
J Thorac Cardiovasc Surg. 1988 Aug;96(2):288-93.
Cineangiograms were available for a quantitative retrospective study along with complete clinical information in 96 patients who underwent intracardiac repair of tetralogy of Fallot with pulmonary atresia. Multivariate analysis determined that the risk factors for too high a ratio (greater than or equal to 1) between the peak pressure in the right ventricle and that in the left, in the operating room about 30 minutes after repair, were as follows: size of the patient, small size of the right and left pulmonary arteries, and a larger number of large aortopulmonary collateral arteries. When, according to the multivariate equation, the predicted probability of this ratio being equal to or greater than 1 is 50% or more, consideration may be given to preliminary operations before repair; when the predicted probability is 70% or more, complete repair at that stage may be unwise.
对96例接受法洛四联症合并肺动脉闭锁心内修复术的患者，可获取心血管造影照片用于定量回顾性研究，并伴有完整的临床信息。多因素分析确定，修复术后约30分钟在手术室，右心室与左心室峰值压力之比过高（大于或等于1）的危险因素如下：患者体型、左右肺动脉细小、大量主动脉-肺动脉侧支动脉。根据多因素方程，当该比值等于或大于1的预测概率为50%或更高时，可考虑在修复术前进行初步手术；当预测概率为70%或更高时，在该阶段进行完全修复可能不明智。
