Jonas R A, Castaneda A R, Norwood W I, Freed M D
Aust N Z J Surg. 1985 Feb;55(1):39-44. doi: 10.1111/j.1445-2197.1985.tb00852.x.
Pulmonary valve stenosis may require urgent surgical relief in infancy or elective valvotomy in childhood. A retrospective study has been made of 94 children who underwent pulmonary valvotomy for pulmonary valve stenosis between 1972 and 1983 using the technique of normothermic caval inflow occlusion. There were no early deaths nor late deaths. The group included 13 neonates less than 1 week old and 14 other infants under 1 year of age. The mean follow-up is 45 months. No child has had a second valvotomy for recurrent valvar stenosis. Two children have required re-operation for placement of a transannular right ventricular outflow patch for hypoplastic pulmonary annulus. Neonates who present early with critical pulmonary valve stenosis may remain moderately to severely cyanosed for several days after a satisfactory valvotomy but this is almost invariably followed by a progressive increase in oxygen saturation to an acceptable level. One neonate, who had a Blalock-Taussig shunt at 2 weeks of age for persistent postvalvotomy cyanosis, had the shunt ligated at 2 years. Pulmonary valvotomy under normothermic caval inflow occlusion is a safe, cost-effective technique which provides excellent early and late haemodynamic results. This operation sets a standard against which the newly introduced technique of percutaneous balloon pulmonary valvotomy should be assessed.
肺动脉瓣狭窄可能需要在婴儿期进行紧急手术缓解，或在儿童期进行择期瓣膜切开术。对1972年至1983年间采用常温腔静脉血流阻断技术因肺动脉瓣狭窄接受肺动脉瓣膜切开术的94名儿童进行了回顾性研究。无早期死亡和晚期死亡病例。该组包括13名小于1周龄的新生儿和14名1岁以下的其他婴儿。平均随访时间为45个月。没有儿童因复发性瓣膜狭窄而接受二次瓣膜切开术。两名儿童因发育不良的肺动脉瓣环需要重新手术放置跨环右心室流出道补片。早期出现严重肺动脉瓣狭窄的新生儿在瓣膜切开术满意后可能会持续数天中度至重度发绀，但随后氧饱和度几乎总会逐渐升高至可接受水平。一名新生儿在2周龄时因瓣膜切开术后持续发绀接受了Blalock-Taussig分流术，在2岁时结扎了分流管。常温腔静脉血流阻断下的肺动脉瓣膜切开术是一种安全、经济有效的技术，可提供良好的早期和晚期血流动力学结果。该手术设定了一个标准，据此应评估新引入的经皮球囊肺动脉瓣膜切开术技术。
