Norwood W I, Lang P, Castaneda A R, Murphy J D
J Thorac Cardiovasc Surg. 1983 Nov;86(5):771-6.
On the basis of experience with older children, creation of a double-outlet ventricle by interposition of a valved conduit between the apex of the left ventricle and the thoracic aorta appeared to be an option for treating life-threatening left ventricular outflow tract obstruction even in the small heart of the infant. Over the recent 3 year period, nine infants ranging in age from 3 days to 13 months with various forms of left ventricular outflow tract obstruction underwent placement of an apical-aortic conduit to decompress the hypertensive left ventricle. There were two early and two late deaths. Five patients are clinically well and developing normally 5 to 23 months following the operation. This series demonstrates that this operation permits normal growth and development in infants previously failing to thrive. Echocardiographic and cardiac catheterization data suggest that left ventricular function need not be adversely affected by placement of a stent in the small infant ventricle; rather, ventricular function can be markedly improved. Although the mortality in this series is appreciable, it appears that apical-aortic conduit interposition can provide significant palliation for infants with otherwise lethal left ventricular outflow tract obstruction.
基于对大龄儿童的治疗经验，通过在左心室心尖与胸主动脉之间置入带瓣管道来构建双出口心室，似乎是治疗危及生命的左心室流出道梗阻的一种选择，即便对于婴儿的小心脏也是如此。在最近3年期间，9例年龄从3天至13个月、患有各种形式左心室流出道梗阻的婴儿接受了心尖-主动脉管道置入术，以减轻左心室高压。有2例早期死亡和2例晚期死亡。5例患者在术后5至23个月临床状况良好且发育正常。该系列病例表明，此手术可使先前生长发育不良的婴儿实现正常生长发育。超声心动图和心导管检查数据表明，在小婴儿心室中置入支架不一定会对左心室功能产生不利影响；相反，心室功能可得到显著改善。尽管该系列病例的死亡率较高，但心尖-主动脉管道置入术似乎可为患有其他致命性左心室流出道梗阻的婴儿提供显著的姑息治疗。
