Tláskal T, Emmrich K, Hucín B, Chares M, Fiser B, Samánek M, Hruda J
Cor Vasa. 1985;27(5):353-63.
Total repair of tetralogy of Fallot was performed in 69 patients after the primary construction of a Blalock (28 patients) or a Waterston (41 patients) anastomosis. A total of 7 patients (10.1%) died. One to 5 yrs after correction, 62 patients (89.9%) survive: 52 (75.4%) are in a very good condition, 7 (10.1%) are in a good condition and the condition of 3 (4.4%) is unsatisfactory. 8 (11.6%) patients have serious late complications. The result of correction is not much influenced by the previous Blalock anastomosis (mortality rate 6.9%). After the Waterston anastomosis, however, there are frequent serious complications (pulmonary hypertension in 25.0% of patients), which adversely affect the result and increase mortality (12.5%) of the subsequent correction. The authors prefer two-stage repair of tetralogy of Fallot in the first two years of life. By administration of beta-blockers and prostaglandins they endeavour to postpone the construction of a Blalock anastomosis or an anastomosis performed by means of a polytetrafluoroethylene vascular prosthesis up to the age when the pulmonary artery branches are at least 4 mm in diameter. They plan the subsequent correction to be performed between the 2nd and the 5th year of age.
69例法洛四联症患者在先行布劳洛克（28例）或沃特斯顿（41例）吻合术后接受了根治手术。共有7例患者（10.1%）死亡。矫正术后1至5年，62例患者（89.9%）存活：52例（75.4%）情况良好，7例（10.1%）情况尚可，3例（4.4%）情况不佳。8例（11.6%）患者出现严重的晚期并发症。先前的布劳洛克吻合术对矫正结果影响不大（死亡率6.9%）。然而，沃特斯顿吻合术后，常出现严重并发症（25.0%的患者发生肺动脉高压），这对结果产生不利影响，并增加了后续矫正手术的死亡率（12.5%）。作者倾向于在患儿生命的头两年对法洛四联症进行两期修复。通过使用β受体阻滞剂和前列腺素，他们努力将布劳洛克吻合术或使用聚四氟乙烯血管假体进行的吻合术推迟到肺动脉分支直径至少为4毫米的年龄。他们计划在患儿2至5岁之间进行后续矫正手术。
