Lamb R K, Qureshi S A, Wilkinson J L, Arnold R, West C R, Hamilton D I
Department of Paediatric Cardiology, Royal Liverpool Children's Hospital, England.
J Thorac Cardiovasc Surg. 1988 Sep;96(3):368-75.
Between 1968 and 1985, 80 children underwent correction of total anomalous pulmonary venous drainage. There were 47 boys and 33 girls whose ages ranged from 3 days to 16 years (median 2 months, interquartile range 5 years). Seventy (87.5%) were less than 1 year of age at operation. Fifty-eight (72.5%) weighed less than 5 kg, the range being 1.6 to 42 kg (median 3.7 kg, interquartile range 2.4 kg). Forty-five (56%) patients had supracardiac, 14 (17.5%) cardiac, 15 (19%) infracardiac, and 6 (7.5%) had mixed total anomalous pulmonary venous drainage. Follow-up was complete in 78 (97.5%) and ranged from 6 to 189 months (median 58 months, interquartile range 59 months). There were 14 (17.5%) early and six (7.5%) late deaths. Analysis by various factors revealed year of operation as the only factor to affect survival at the 5% level of significance. Early mortality was 29% between 1968-1977 and 11% between 1978-1985 (p = 0.04). Postoperative pulmonary venous obstruction occurred in five (6%) patients between 6 weeks and 3 months after operation. All 5 died, three after reoperation. Five (6%) other children had reoperations, four for residual shunts and one for superior vena caval obstruction.
1968年至1985年间，80名儿童接受了完全性肺静脉异位引流矫治术。其中男47例，女33例，年龄从3天至16岁（中位数2个月，四分位间距5年）。70例（87.5%）手术时年龄小于1岁。58例（72.5%）体重小于5 kg，范围为1.6至42 kg（中位数3.7 kg，四分位间距2.4 kg）。45例（56%）患者为心上型完全性肺静脉异位引流，14例（17.5%）为心内型，15例（19%）为心下型，6例（7.5%）为混合型完全性肺静脉异位引流。78例（97.5%）获得完整随访，随访时间为6至189个月（中位数58个月，四分位间距59个月）。早期死亡14例（17.5%），晚期死亡6例（7.5%）。多因素分析显示，手术年份是唯一在5%显著性水平影响生存的因素。1968 - 1977年间早期死亡率为29%，1978 - 1985年间为11%（p = 0.04）。5例（6%）患者术后6周 至3个月出现肺静脉梗阻。5例均死亡，3例为再次手术后死亡。另外5例（6%）儿童接受了再次手术，4例因残余分流，1例因上腔静脉梗阻。
