Lillehei C W, Varco R L, Cohen M, Warden H E, Patton C, Moller J H
Ann Thorac Surg. 1986 Jan;41(1):4-21. doi: 10.1016/s0003-4975(10)64489-x.
From March 26, 1954, to July 19, 1955, 45 patients with major cardiac malformations not previously correctable underwent open repair utilizing cross-circulation between patient and donor without donor deaths. All operations were carried out at normothermia with lowered flow rates based on azygos flow studies. Twenty-seven patients, more than half of them infants, had ventricular septal defects closed. There were 8 hospital deaths, and there have been only 2 late deaths in 30 years. Fourteen (87.5%) of 16 who underwent recatheterization have closed defects. The 17 30-year-survivors are all in New York Heart Association Functional Class I. Five patients 4 months to 10 years old were operated on for atrioventricular canal (complete form). All had intractable failure, and 4 had pulmonary hypertension. Two of the 3 hospital deaths were due to heart block. The long-term survivor, a 15-month-old infant at the time of operation (severe pulmonary hypertension, 90/50 mm Hg), underwent repair 31 years ago and is now married with 3 children. Recatheterization disclosed normal pulmonary pressure (20/4 mm Hg), no shunts, and mild mitral regurgitation. Ten cyanotic tetrads 13 months to 14 years old were operated on with 5 hospital deaths. Of the 3 late deaths, 1 was accidental at 17 years, 1 occurred suddenly at home 13 years after operation in infancy for atresia, and the third occurred at reoperation 10 years later. The 2 remaining patients (1 the first patient operated on) are in excellent health. The surgical methods used and the physiological advantages of cross-circulation (temporary placenta) that made these results possible at a time when surgical knowledge was primitive are described.
1954年3月26日至1955年7月19日，45例先前无法矫治的严重心脏畸形患者接受了开放性修复手术，采用患者与供体之间的交叉循环，无供体死亡。所有手术均在常温下进行，根据奇静脉血流研究降低流速。27例患者（其中一半以上为婴儿）的室间隔缺损得以闭合。有8例住院死亡，30年来仅有2例晚期死亡。16例接受再次导管检查的患者中有14例（87.5%）缺损已闭合。17名30年幸存者均处于纽约心脏协会心功能I级。5例年龄在4个月至10岁的患者接受了房室管（完全型）手术。所有患者均有难治性心力衰竭，4例有肺动脉高压。3例住院死亡中有2例死于心脏传导阻滞。长期存活者在手术时为15个月大的婴儿（重度肺动脉高压，90/50 mmHg），31年前接受了修复手术，现已结婚并有3个孩子。再次导管检查显示肺动脉压力正常（20/4 mmHg），无分流，轻度二尖瓣反流。10例年龄在13个月至14岁的青紫型四联症患者接受了手术，5例住院死亡。3例晚期死亡中，1例17岁时意外死亡，1例婴儿期因闭锁手术后13年在家中突然死亡，第例在10年后再次手术时死亡。其余2例患者（1例为首例手术患者）健康状况良好。文中描述了所采用的手术方法以及交叉循环（临时胎盘）的生理优势，正是这些优势在外科知识尚不完善的时期使得这些结果成为可能。
