John S, Korula R, Jairaj P S, Muralidharan S, Ravikumar E, Babuthaman C, Sathyamoorthy I, Krishnaswamy S, Cherian G, Sukumar I P
Thorax. 1983 Apr;38(4):279-83. doi: 10.1136/thx.38.4.279.
Two hundred and twenty-five consecutive patients with interventricular septal defect and associated pulmonary hypertension have undergone corrective surgery at the Christian Medical College Hospital. The mean preoperative systolic pulmonary artery pressure was 70.5 (range 31-136) mm Hg and the calculated pulmonary vascular resistance ranged from 300 to 1680 dyn/s cm-5. A paracoronary right ventriculotomy was the approach of choice. Profound hypothermia and circulatory arrest were not used, even in 12 patients weighing under 10 kg. Among the older children and young adolescents there were 27 who had a calculated pulmonary vascular resistance of over 800 dyn/s cm-1 and their mortality was 22%, which is good when compared with that of other series. It is evident that both the early and the late death rate after surgery increase with the age of the patient, especially in those with associated pulmonary hypertension. In 69 patients studied after repair recatheterisation showed no residual defect by oximetry. The fall in the pulmonary artery pressures after surgery has been striking in most patients. The late death rate was 2.5%. The surviving patients are leading normal, active lives.
225例患有室间隔缺损并伴有肺动脉高压的连续患者在基督教医学院医院接受了矫正手术。术前肺动脉收缩压平均为70.5（范围31 - 136）mmHg，计算得出的肺血管阻力范围为300至1680 dyn/s cm⁻⁵。冠状旁右心室切开术是首选的手术方法。即使在12例体重不足10 kg的患者中，也未使用深度低温和循环停止技术。在年龄较大的儿童和青少年中，有27例计算得出的肺血管阻力超过800 dyn/s cm⁻¹，他们的死亡率为22%，与其他系列相比这是较好的。很明显，手术后的早期和晚期死亡率均随患者年龄增加，尤其是伴有肺动脉高压的患者。在69例修复后接受研究的患者中，再次导管检查通过血氧测定显示无残余缺损。大多数患者术后肺动脉压力下降显著。晚期死亡率为2.5%。存活的患者过着正常、活跃的生活。
