Jonas R A, Castaneda A R, Freed M D
J Thorac Cardiovasc Surg. 1985 May;89(5):780-6.
The technique of normothermic caval inflow occlusion was introduced primarily for relief of pulmonary valve stenosis and continues to be used for this purpose with excellent results. However, the technique may also be applied to a number of other lesions such as aortic valve stenosis in neonates and infants, for placement of outflow patches or valve excision for pulmonary atresia with intact ventricular septum, for atrial septectomy in children with restrictive atrial septum, and for other conditions wherein a period of up to 2 minutes of intracardiac exposure is sufficient. This report examines the early and long-term results in 140 children who underwent normothermic caval inflow occlusion at The Children's Hospital, Boston, Massachusetts, over the past 11 years. Ninety-four children underwent pulmonary valvotomy (early mortality 0%), 21 had aortic valvotomy (19%), 10 with pulmonary atresia and intact ventricular septum underwent various procedures (50%), 11 had atrial septectomy (9%), and there were four miscellaneous procedures (50%). Apart from avoiding many of the potential complications of cardiopulmonary bypass, inflow occlusion has provided as good or better short-term and long-term results as those obtained with cardiopulmonary bypass, particularly in infants and neonates, and also has proved more cost effective.
常温下腔静脉血流阻断技术最初是为缓解肺动脉瓣狭窄而引入的，目前仍用于此目的，效果良好。然而，该技术也可应用于许多其他病变，如新生儿和婴儿的主动脉瓣狭窄、为室间隔完整的肺动脉闭锁放置流出道补片或进行瓣膜切除、为限制性房间隔的儿童进行房间隔切除术，以及适用于心内暴露时间长达2分钟就足够的其他情况。本报告研究了过去11年在马萨诸塞州波士顿儿童医院接受常温下腔静脉血流阻断术的140名儿童的早期和长期结果。94名儿童接受了肺动脉瓣切开术（早期死亡率0%），21名接受了主动脉瓣切开术（19%），10名室间隔完整的肺动脉闭锁患儿接受了各种手术（50%），11名接受了房间隔切除术（9%），还有4名接受了其他杂项手术（50%）。除了避免体外循环的许多潜在并发症外，血流阻断术在短期和长期都取得了与体外循环相当或更好的效果，尤其是在婴儿和新生儿中，而且已证明更具成本效益。
