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法洛四联症的外科治疗结果:马拉喀什穆罕默德六世大学医院心血管科的经验

Surgical Treatment Outcomes of Tetralogy of Fallot: Experience of the Cardiovascular Department of the Mohammed VI University Hospital in Marrakech.

作者信息

Tandia Ahmed Salah, El Qady Marwan, El Karimi Saloua, Boumzebra Driss

机构信息

Department of Cardiology and Vascular Diseases, Mohammed VI University Hospital, Marrakech, MAR.

Department of Cardiovascular Surgery, Mohammed VI University Hospital, Marrakech, MAR.

出版信息

Cureus. 2022 May 6;14(5):e24773. doi: 10.7759/cureus.24773. eCollection 2022 May.

DOI:10.7759/cureus.24773
PMID:35677003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9167490/
Abstract

Background Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. The surgical approach to TOF continues to evolve, with many centers now favoring early repair for TOF. This study aimed to determine the prevalence of postsurgical complications such as pulmonary insufficiency, residual pulmonary stenosis, and interventricular communication. Methodology We conducted a cross-sectional, observational study with a descriptive and analytic focus involving 61 patients who were operated on for TOF. Results In total, 39 (63.9%) patients had a regular TOF and 22 (36.1%) had an irregular TOF. In our study, 32 (56.14%) patients had a pulmonary insufficiency, of whom 20 had a minimal pulmonary insufficiency (62.5% of pulmonary insufficiency cases), and 79.4% of patients with right ventricular outflow tract enlargement had pulmonary insufficiency (p < 0.005). Among patients who did not have a right ventricular outflow tract enlargement, three cases of pulmonary insufficiency were identified with a prevalence of 16.6%. Six (10.52%) patients had residual pulmonary stenosis. In addition, two (3.2%) cases of minimal residual ventricular septal defects were identified in this study. Conclusions Postoperative complications of TOF treatment are frequent and require medical care throughout the lifetime of patients.

摘要

背景 法洛四联症(TOF)是最常见的青紫型先天性心脏病。TOF的手术方法不断发展,现在许多中心倾向于对TOF进行早期修复。本研究旨在确定术后并发症的发生率,如肺动脉瓣关闭不全、残余肺动脉狭窄和室间隔交通。方法 我们进行了一项横断面观察性研究,以描述性和分析性为重点,纳入了61例接受TOF手术的患者。结果 总共,39例(63.9%)患者为典型TOF,22例(36.1%)为非典型TOF。在我们的研究中,32例(56.14%)患者有肺动脉瓣关闭不全,其中20例有轻度肺动脉瓣关闭不全(占肺动脉瓣关闭不全病例的62.5%),右心室流出道扩大的患者中有79.4%有肺动脉瓣关闭不全(p<0.005)。在没有右心室流出道扩大的患者中,发现3例肺动脉瓣关闭不全,发生率为16.6%。6例(10.52%)患者有残余肺动脉狭窄。此外,本研究中发现2例(3.2%)轻度残余室间隔缺损病例。结论 TOF治疗的术后并发症很常见,患者一生都需要医疗护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/bb34aa18182e/cureus-0014-00000024773-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/327bd06c1e5c/cureus-0014-00000024773-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/716c22335949/cureus-0014-00000024773-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/7237676dcedd/cureus-0014-00000024773-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/bb34aa18182e/cureus-0014-00000024773-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/327bd06c1e5c/cureus-0014-00000024773-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/716c22335949/cureus-0014-00000024773-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/7237676dcedd/cureus-0014-00000024773-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8148/9167490/bb34aa18182e/cureus-0014-00000024773-i04.jpg

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本文引用的文献

1
Valve-Sparing or Valve Reconstruction Options in Tetralogy of Fallot Surgery.法洛四联症手术中的保留瓣膜或瓣膜重建选择
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2017 Jan;20:79-83. doi: 10.1053/j.pcsu.2016.09.001.
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Tetralogy of Fallot: General Principles of Management.法洛四联症:管理的一般原则
Cardiol Clin. 2015 Nov;33(4):531-41, vii-viii. doi: 10.1016/j.ccl.2015.07.002. Epub 2015 Aug 29.
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[Follow-up of tetralogy of Fallot after repair].法洛四联症修复术后的随访
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5
Outcome after repair of tetralogy of Fallot in the first year of life.法洛四联症在生命第一年进行修复后的结果。
Ann Thorac Surg. 2001 Feb;71(2):494-500. doi: 10.1016/s0003-4975(00)02444-9.