Macmanus Q, Starr A, Lambert L E, Grunkemeier G
Ann Thorac Surg. 1977 Dec;24(6):544-9. doi: 10.1016/s0003-4975(10)63455-8.
To determine those factors that affect mortality and to analyze long-term results, the records of 44 infants who underwent repair of aortic coarctation at less than 90 days of age were examined. There were 14 operative and 8 late deathes (mean, 4.3 months postoperatively). Subsequent operation, generally to repair or palliate associated anomalies, was required 22 times in 20 patients and was a source of considerable mortality. There is evidence that earlier total repair of associated anomalies might improve survival. Sufficient data were available on 17 of the 22 survivors to assess long-term results. The outcome was considered excellent in 8 patients, fair in 4, and poor in 5. Revision of the coarctation repair due to growth failure of the anastomosis was required in 1 patient. Aggressive surgical management is recommended in these infants because, despite a high early mortality, a considerable proportion of excellent results can be anticipated in what is otherwise a hopeless situation.
为了确定影响死亡率的因素并分析长期结果,我们检查了44例在90日龄以内接受主动脉缩窄修复手术的婴儿的记录。有14例手术死亡和8例晚期死亡(平均术后4.3个月)。20例患者中有22次需要进行后续手术,通常是为了修复或缓解相关畸形,这是相当高死亡率的一个来源。有证据表明,早期对相关畸形进行完全修复可能会提高生存率。在22名幸存者中有17名有足够的数据来评估长期结果。8例患者的结果被认为优秀,4例为中等,5例为差。1例患者因吻合口生长失败需要对缩窄修复进行修正。建议对这些婴儿进行积极的手术治疗,因为尽管早期死亡率很高,但在其他情况下无望的情况下,可以预期相当一部分会有优秀的结果。