Bianchi T, Gamba A, Parenzan L
Thorac Cardiovasc Surg. 1984 Aug;32(4):229-33. doi: 10.1055/s-2007-1023391.
The policy for surgical treatment of tetralogy of Fallot in younger patients is still controversial. Our overall 14-year experience has been reviewed with regard to the factors influencing mortality for both shunts and corrective procedures. An attempt has been made to evaluate our current expected cumulative mortality for two-stage correction in patients under 2 years of age. From November, 1966 through April, 1983, 440 shunts and 647 total corrections were performed. Patients under 2 years of age, and those with unfavorable anatomy and/or physiology, generally underwent two-stage correction. Early correction was occasionally performed in this age group on patients with very favorable anatomy, or in case of early shunt failure. Retrospective standard statistical analysis was carried out in order to evaluate the influences of the year of operation, age, and operative technique on mortality. The overall early mortality of shunt procedures was 5.7% (11.4% below and 3.5% over 6 months of age). Since 1978 it has dropped to 2.8% (4.2% below and 2.1% over 6 months). The Waterston shunt had a higher (7%) operative mortality than the Blalock (3%) or Goretex (2.6%) shunts. The overall early mortality of total corrections was 15.1% (25.2% below and 13.5% over 2 years of age). It has dropped to 6.9% since 1978 (29.9% below and 6.2% over 2 years).(ABSTRACT TRUNCATED AT 250 WORDS)
低龄法洛四联症患者的外科治疗策略仍存在争议。我们回顾了14年的总体经验，涉及分流术和矫正手术中影响死亡率的因素。我们尝试评估目前2岁以下患者接受两阶段矫正的预期累积死亡率。1966年11月至1983年4月，共进行了440例分流术和647例完全矫正术。2岁以下患者以及解剖结构和/或生理状况不佳的患者，一般接受两阶段矫正。该年龄组中，解剖结构非常良好的患者或分流术早期失败的患者偶尔会接受早期矫正。为了评估手术年份、年龄和手术技术对死亡率的影响，进行了回顾性标准统计分析。分流术的总体早期死亡率为5.7%（6个月以下为11.4%，6个月以上为3.5%）。自1978年以来，已降至2.8%（6个月以下为4.2%，6个月以上为2.1%）。沃特斯顿分流术的手术死亡率（7%）高于布莱洛克分流术（3%）或戈尔特斯分流术（2.6%）。完全矫正术的总体早期死亡率为15.1%（2岁以下为25.2%，2岁以上为13.5%）。自1978年以来，已降至6.9%（2岁以下为29.9%，2岁以上为
