Oku H, Shirontani H, Sunakawa A, Yokoyama T
Ann Thorac Surg. 1986 Apr;41(4):413-8. doi: 10.1016/s0003-4975(10)62698-7.
Late results were assessed in 63 patients who underwent complete repair of tetralogy of Fallot. These patients were divided into four groups. Group I-A included 13 who had a transannular patch with a monocusp, and whose cross-sectional area index (CSAI) was less than 2.5 cm2/m2; group I-B included 11 with the patch and with a CSAI greater than 2.5 cm2/m2. Group II included 27 patients who underwent pulmonary valvotomy. Group III included 9 who had not undergone valvotomy and 3 who had undergone pulmonary valve replacement. Late death occurred in 1 patient, and reoperation was done on 3. Mild pulmonary stenosis (PS) was present in 73%, moderate PS in 17%, and severe PS in 10% of the patients. A significant pulmonary regurgitation (PR) of grade 3 or 4 was present in 33% of the patients in group I-A, and in 87% of group I-B, 17% of group II, and 0% of group III. Right ventricular end-diastolic volume was normal in patients with a PR of grade 2 or less, and it was higher in patients who had a significant PR. The ejection fraction was generally decreased, regardless of the grade of PR. Left ventricular function was normal in those with a PR of grade 3 or less and was impaired in those with a PR of grade 4. Thus, late postoperative hemodynamics and ventricular function were excellent in patients with a mild PS and a PR of grade 2 or less and it was poor in those with a moderate PS and a significant PR.(ABSTRACT TRUNCATED AT 250 WORDS)
对63例接受法洛四联症完全修复术的患者的远期结果进行了评估。这些患者被分为四组。I - A组包括13例接受单瓣跨环补片且横截面积指数（CSAI）小于2.5 cm²/m²的患者；I - B组包括11例接受该补片且CSAI大于2.5 cm²/m²的患者。II组包括27例行肺动脉瓣切开术的患者。III组包括9例未行瓣膜切开术的患者和3例行肺动脉瓣置换术的患者。1例患者发生晚期死亡，3例患者接受了再次手术。73%的患者存在轻度肺动脉狭窄（PS），17%为中度PS，10%为重度PS。I - A组33%的患者、I - B组87%的患者、II组17%的患者以及III组0%的患者存在3级或4级的显著肺动脉反流（PR）。PR为2级或以下的患者右心室舒张末期容积正常，而有显著PR的患者该容积更高。无论PR分级如何，射血分数总体上均降低。PR为3级或以下的患者左心室功能正常，PR为4级的患者左心室功能受损。因此，轻度PS且PR为2级或以下的患者术后晚期血流动力学和心室功能良好，而中度PS且有显著PR的患者则较差。（摘要截选至250字）
