Presbitero P, D'Antonio P, Brusca A, Morea M
Pediatr Cardiol. 1983 Jul-Sep;4(3):175-82. doi: 10.1007/BF02242252.
The condition of 350 patients with Fallot's tetralogy (FT) who had palliative surgery (aortopulmonary shunt or transventricular valvotomy) was reviewed 10-25 years later: 136 patients (38%) are alive without any further operation, 106 (30%) have recovered completely, and 108 (31%) have died. Actuarial survival at 25 years of the patients who had palliation was 50% compared to 83% for the group who subsequently had complete correction. After the first five years the mortality rates became 5% per year. Of the patients who were not reoperated upon, 33% felt that the quality of their life was normal, 40% were limited, and 27% were severely limited. The older the patient at palliative procedure, the better the clinical course and the longer the interval before another operation, if the latter was needed at all. Of the patients who had a Brock procedure, the survival rate at 25 years was 80% and the clinical condition was good in 72% of the patients who had not been reoperated upon. Comparison with the natural history of unoperated FT reported by others indicates that the palliative procedures prolonged life in our series; mortality continued at a steady rate for a few years after palliative surgery, probably as a function of the severity of the anatomical and functional abnormality, and independently of the age at which the palliative procedure was performed. Among the palliative procedures, the Brock operation was followed by the best results both in relieving symptoms and in prolonging life.
对350例接受姑息性手术（体肺分流术或经心室瓣膜切开术）的法洛四联症（FT）患者在10至25年后的情况进行了回顾：136例患者（38%）存活且无需进一步手术，106例（30%）已完全康复，108例（31%）死亡。接受姑息治疗患者25年的精算生存率为50%，而随后接受完全矫正的患者组为83%。头五年后，死亡率变为每年5%。在未接受再次手术的患者中，33%认为其生活质量正常，40%受到限制，27%受到严重限制。进行姑息手术时患者年龄越大，临床病程越好，如需再次手术，两次手术间隔时间越长。接受布罗克手术的患者中，25年生存率为80%，未接受再次手术的患者中72%临床状况良好。与其他人报道的未经手术的FT自然病程相比，表明我们系列中的姑息性手术延长了生命；姑息性手术后几年死亡率持续稳定，这可能与解剖和功能异常的严重程度有关，与进行姑息性手术时的年龄无关。在姑息性手术中，布罗克手术在缓解症状和延长生命方面都取得了最佳效果。
