Walker D R, Sbokos C G, Lennox S C
Br Heart J. 1975 Mar;37(3):282-6. doi: 10.1136/hrt.37.3.282.
Although Fontan and Baudet in 1971 described a physiological correction procedure for tricuspid atresia, very few successful operations have been reported. Two patients corrected 20 and 10 months ago at the Brompton Hospital are presented. These two patients exhibit many of the problems in the management of tricuspid atresia. The first patient aged 20 had undergone three previous palliative operations, a Blalock-Taussig shunt, a Glenn procedure, and an infundibular resection, and therefore presented a number of operative problems. In contrast the second patient, aged 8, whose condition had deteriorated considerably over the previous year, had had no previous surgical treatment. At operation he was found, in addition, to have a partial atrioventricular canal. Details of the operative procedures and the patients' postoperative course are described. The criteria for selection of patients for the Fontan operation are discussed as are the possible long-term hazards of homograft failure, atrial dysrhythmias, and hepatic dysfunction. The successful outcome of these two patients suggests that palliative surgery in infancy should allow for this form of correction in later life.
尽管1971年丰坦和鲍代描述了一种针对三尖瓣闭锁的生理性矫正手术，但成功实施该手术的报道却很少。本文介绍了两名分别于20个月和10个月前在布朗普顿医院接受矫正手术的患者。这两名患者呈现出三尖瓣闭锁治疗过程中的诸多问题。第一名患者20岁，此前已接受过三次姑息性手术，即布莱洛克 - 陶西格分流术、格伦手术和漏斗部切除术，因此存在一些手术难题。相比之下，第二名患者8岁，其病情在过去一年中明显恶化，此前未接受过手术治疗。此外，术中发现他还患有部分房室通道畸形。文中描述了手术过程细节及患者术后病程。讨论了丰坦手术患者的选择标准以及同种异体移植失败、房性心律失常和肝功能障碍等可能的长期风险。这两名患者的成功治疗结果表明，婴儿期的姑息性手术应为后期进行这种矫正手术创造条件。
