Fyfe D A, Driscoll D J, Di Donato R M, Puga F J, Danielson G K, McGoon D C, Mair D D
J Am Coll Cardiol. 1985 May;5(5):1168-72. doi: 10.1016/s0735-1097(85)80020-6.
Nineteen patients with truncus arteriosus and single pulmonary artery had corrective operations at the Mayo Clinic from 1969 to 1983. At operation, their ages ranged from 4 months to 20 years (mean 8.1 years). The preoperative pulmonary resistance divided by 2 was used to predict the degree of pulmonary vascular obstructive disease at operation. The influence of elevated pulmonary resistance and the intraoperative postrepair ratio of pulmonary artery to left ventricular pressure on operative and late mortality were examined. The outcome of patients with single pulmonary artery was compared with the outcome of 148 patients with truncus arteriosus and two pulmonary arteries operated on during the same period. Patients with a single pulmonary artery had an operative mortality similar to that of patients with two pulmonary arteries (32 versus 28%, p greater than 0.05). Late mortality was, however, significantly greater (p less than 0.001) for patients with a single pulmonary artery. Elevated ratios of intraoperative postrepair pulmonary artery to left ventricular pressure were associated with significantly higher (p less than 0.02) operative and late mortality, but elevated preoperative pulmonary resistance was not (p greater than 0.10). Truncus arteriosus with single pulmonary artery is associated with poor postoperative survival, and although elevated pulmonary resistances preoperatively did not predict outcome, elevated intraoperative postrepair pulmonary artery to left ventricular pressure ratios were associated with increased operative and late survival, suggesting a deleterious role of pulmonary hypertension.
1969年至1983年期间，19例患有共同动脉干和单支肺动脉的患者在梅奥诊所接受了矫正手术。手术时，他们的年龄从4个月到20岁不等（平均8.1岁）。术前肺阻力除以2用于预测手术时肺血管阻塞性疾病的程度。研究了肺阻力升高以及术中修复后肺动脉与左心室压力之比对手术和晚期死亡率的影响。将单支肺动脉患者的预后与同期接受手术的148例共同动脉干合并两支肺动脉患者的预后进行了比较。单支肺动脉患者的手术死亡率与两支肺动脉患者相似（分别为32%和28%，p>0.05）。然而，单支肺动脉患者的晚期死亡率显著更高（p<0.001）。术中修复后肺动脉与左心室压力之比升高与手术和晚期死亡率显著升高相关（p<0.02），但术前肺阻力升高则不然（p>0.10）。共同动脉干合并单支肺动脉与术后生存率低有关，虽然术前肺阻力升高不能预测预后，但术中修复后肺动脉与左心室压力之比升高与手术和晚期生存率增加相关，提示肺动脉高压具有有害作用。
