Mansfield P B, Hall D G, Rittenhouse E A, Sauvage L R, Stamm S J, Herndon P S, Furman E C
J Thorac Cardiovasc Surg. 1979 Jun;77(6):816-25.
To assess the current status and risks of both open and closed cardiac procedures for congenital heart disease in patients under the age of 2 years, we reviewed all cardiac catheterizations and cardiac operations done from January, 1974, through December, 1977, at The Children's Orthopedic Hospital and Medical Center in Seattle, Washington. In this interval 370 patients under 2 years of age were catheterized. Eighty open procedures were performed in patients under 2 years of age, with seven hospital deaths. One hundred twenty-four closed heart procedures were performed on children under the age of 2 years, with eight deaths, for a hospital mortality rate of 6.5 percent. This review of consecutive cases over a 4 year period suggests that the judicious application of palliation or open repair using current techniques can lead to an overall mortality rate of between 6 and 7 percent for both open and closed heart procedures in children under 2 years of age. Since all deaths except one in the open-heart group occurred in patients with the most complex multiple defects, it seems reasonable to suggest that improved intraoperative and postoperative techniques have lowered the time for repair of straightforward congenital heart defects to under 2 years of age.
为评估2岁以下先天性心脏病患者进行心脏直视手术和非心脏直视手术的现状及风险，我们回顾了1974年1月至1977年12月在华盛顿州西雅图市儿童矫形医院及医疗中心所做的所有心导管检查及心脏手术。在此期间，对370名2岁以下患者进行了心导管检查。对80名2岁以下患者实施了心脏直视手术，其中7例患者在医院死亡。对124名2岁以下儿童实施了非心脏直视手术，8例死亡，医院死亡率为6.5%。对连续4年病例的回顾表明，明智地应用目前技术进行姑息治疗或心脏直视修复，可使2岁以下儿童心脏直视手术和非心脏直视手术的总体死亡率在6%至7%之间。由于心脏直视手术组除1例死亡外，所有死亡均发生在有最复杂多种缺陷的患者中，因此似乎有理由认为，改进的术中和术后技术已将单纯先天性心脏病缺损的修复时间缩短至2岁以下。
