Spicer R L, Behrendt D, Crowley D C, Dick M, Rocchini A P, Uzark K, Rosenthal A, Sloan H
Circulation. 1984 Sep;70(3 Pt 2):I26-9.
Each of seven infants 1 to 9 days old and weighing 2.1 to 3.3 kg with truncus arteriosus underwent repair of their defects with a right ventricular-to-pulmonary artery valveless conduit. Congestive heart failure and cyanosis were present before surgery in each. Five patients survived surgery and one of these subsequently died. Comparison between preoperative hemodynamics of the survivors and nonsurvivors disclosed similar peak systolic pulmonary arterial and aortic pressures, and pulmonary (Rp) or systemic resistance (Rs) in the groups. However, the mean Rp/Rs ratio in survivors (0.15) was significantly less than in nonsurvivors (0.63) (p = .001). The four remaining survivors are asymptomatic 7 months to 5.5 years after operation. Postoperative cardiac catheterization in three patients disclosed proximal conduit obstruction of 10 to 20 mm Hg in each, distal conduit obstruction of 35 mm Hg in two, and mild truncal valve stenosis and moderate truncal regurgitation in one each. We recommend the use of a valveless conduit for the symptomatic neonate with truncus arteriosus and a low Rp/Rs ratio (less than or equal to 0.03).
七名年龄在1至9天、体重2.1至3.3千克的患有共同动脉干的婴儿，均接受了使用右心室至肺动脉无瓣膜管道修复其缺损的手术。每名婴儿术前均存在充血性心力衰竭和发绀症状。五名患者术后存活，其中一名随后死亡。对存活者和非存活者术前血流动力学进行比较发现，两组的收缩期肺动脉和主动脉峰值压力以及肺血管阻力（Rp）或体循环阻力（Rs）相似。然而，存活者的平均Rp/Rs比值（0.15）显著低于非存活者（0.63）（p = 0.001）。其余四名存活者术后7个月至5.5年无症状。三名患者术后心脏导管检查显示，每名患者近端管道阻塞10至20毫米汞柱，两名患者远端管道阻塞35毫米汞柱，一名患者存在轻度共同动脉干瓣膜狭窄和中度共同动脉干反流。我们建议对有症状的共同动脉干新生儿且Rp/Rs比值较低（小于或等于0.03）的患者使用无瓣膜管道。
