Laas J, Engeser U, Meisner H, Struck E, Sauer U, Bühlmeyer K, Zwingers T, Sebening F
Thorac Cardiovasc Surg. 1984 Jun;32(3):133-8. doi: 10.1055/s-2007-1023369.
Thirty-one patients with tetralogy of Fallot were studied angiographically before and after palliation with Blalock-Taussig operation (n = 9), Brock operation (n = 12), or enlargement of the right ventricular outflow tract with extracorporeal circulation (ECC) (n = 10). The relative diameter of the pulmonary vascular ring (PVR), pulmonary trunk (PT), and right and left pulmonary arteries (RPA, LPA) were measured before and 24.8 +/- 20.9 months after palliation. Using correlation analysis, the magnitude of growth of the pulmonary artery system was inversely related to its initial size. Mean pressure in the pulmonary artery after palliation as well as the period between date of surgery and recatheterization did not correlate significantly with growth. After Blalock-Taussig operation, the ipsilateral pulmonary artery predominantly increased in size without significant growth of PVR and PT. Brock operation and enlargement of the right ventricular outflow tract with ECC, improving the flow in the pulmonary vascular system centrally, induced a significant, symmetrical growth of the pulmonary vascular system and, therefore, are our methods of choice for palliation in patients with tetralogy of Fallow combined with hypoplastic pulmonary arteries.
对31例法洛四联症患者在采用布-陶（Blalock-Taussig）手术（n = 9）、布罗克（Brock）手术（n = 12）或体外循环（ECC）下扩大右心室流出道（n = 10）进行姑息治疗前后进行了血管造影研究。在姑息治疗前以及姑息治疗后24.8±20.9个月测量了肺血管环（PVR）、肺动脉干（PT）以及左右肺动脉（RPA、LPA）的相对直径。采用相关性分析，肺动脉系统的生长幅度与其初始大小呈负相关。姑息治疗后肺动脉的平均压力以及手术日期与再次导管插入术之间的时间间隔与生长无显著相关性。布-陶手术之后，同侧肺动脉主要是大小增加，而PVR和PT无显著生长。布罗克手术以及在ECC下扩大右心室流出道，可从中心改善肺血管系统的血流，可引起肺血管系统显著、对称的生长，因此是我们对合并肺发育不全的法洛四联症患者进行姑息治疗的首选方法。
