Oku H, Shirotani H, Yokoyama T, Kawai J, Nishioka T, Oka H, Katayama O, Saga T, Wakaki N
Jpn Circ J. 1984 Oct;48(10):1074-80. doi: 10.1253/jcj.48.1074.
Operative risk factors and postoperative late results were evaluated in 26 patients undergoing pulmonary artery reconstruction with a substitute valve. Seventeen extracardiac conduits bearing a valve were used in 16 patients and an in situ pulmonary valve insertion was carried out in the other 10. The surgical results were influenced by complexity of the underlying cardiac lesions and pulmonary vascular status, with a high mortality rate in patients with several cardiac defects including single ventricle, asplenia syndrome, complete atrioventricular canal etc. The mortality rate was 6% in patients with an immediate post-repair Ppv/sv of less than 0.75 and 77.8% in those with a Ppv/sv over 0.75. Postoperative Ppv/sv was mainly regulated by valve area index and a close correlation was obtained for the regression equation Ppv/sv = 0.41/(VAI)2 + 0.36 (r = -0.61, p less than 0.05). To obtain excellent hemodynamics with a Ppv/sv of less than 0.50, valve area index should be over 1.7 cm2/M2, and to eliminate re-implantation of the conduit after reaching adulthood, the diameter of the conduit should be 18 mm or more and the valve size 23 A, or more when a SJM valve is used.
对26例接受带瓣肺动脉重建术的患者的手术风险因素和术后远期结果进行了评估。16例患者使用了17个带瓣的心外管道，另外10例进行了原位肺动脉瓣植入。手术结果受潜在心脏病变的复杂性和肺血管状况的影响，包括单心室、无脾综合征、完全性房室通道等多种心脏缺陷的患者死亡率较高。修复后即刻Ppv/sv小于0.75的患者死亡率为6%，Ppv/sv大于0.75的患者死亡率为77.8%。术后Ppv/sv主要由瓣叶面积指数调节，回归方程Ppv/sv = 0.41/(VAI)2 + 0.36得出密切相关性（r = -0.61，p小于0.05）。为了在Ppv/sv小于0.50的情况下获得良好的血流动力学，瓣叶面积指数应超过1.7 cm2/M2，为了在成年后避免管道再次植入，当使用SJM瓣膜时，管道直径应在18 mm或以上，瓣膜尺寸应为23 A或更大。
