Lane I, Treasure T, Leijala M, Shinebourne E, Lincoln C
Int J Cardiol. 1983 May;3(2):175-85. doi: 10.1016/0167-5273(83)90034-7.
We have assessed the clinical results and angiographic pulmonary artery growth following construction of the right ventricular outflow tract in 10 children with tetralogy of Fallot or pulmonary atresia. All cases were associated with diminutive pulmonary arteries and considered unsuitable for total corrective surgery. The mean age of the children was 34 months, mean weight 10 kg and mean body surface area 0.48 m2. The right ventricular outflow tract was constructed by insertion of a patch of dura mater (5 patients), pericardium (2 patients), homograft valved conduit (2 patients) and infundibulectomy (1 patient). The ventricular septal defect was not closed. Study of the patients between 13 and 37 months postoperatively revealed an increase in mean arterial oxygen saturation of 22% (P less than 0.01) and a fall in mean haemoglobin concentration of 1.6 g% (P less than 0.05). Overall change in pulmonary artery diameter compared to that of the trachea was insignificant although in individual cases a 50% increase in diameter was shown. Palliation of symptoms was equivalent to conventional shunting procedures. Closure of the ventricular septal defect was performed successfully in 2 patients at a later date.
我们评估了10例法洛四联症或肺动脉闭锁患儿右心室流出道构建后的临床结果及血管造影显示的肺动脉生长情况。所有病例均伴有细小肺动脉，被认为不适合进行根治性手术。患儿的平均年龄为34个月，平均体重10千克，平均体表面积0.48平方米。右心室流出道的构建方法包括：植入硬脑膜补片（5例）、心包补片（2例）、同种异体带瓣管道（2例）以及漏斗部切除术（1例）。室间隔缺损未予闭合。对术后13至37个月的患者进行研究发现，平均动脉血氧饱和度提高了22%（P<0.01），平均血红蛋白浓度下降了1.6 g%（P<0.05）。与气管相比，肺动脉直径的总体变化不显著，不过个别病例显示直径增加了50%。症状缓解情况与传统分流手术相当。2例患者在之后成功进行了室间隔缺损闭合术。
