Müller-Seydlitz P M, Haider M, Woog P M, Reichart B, Klinner W
Thoraxchir Vask Chir. 1978 Aug;26(4):236-40. doi: 10.1055/s-0028-1096630.
22 Fallot patients who had surgery after 21 years of age were thoroughly checked on an average of 11 years postoperatively. The mean functional classification according to the New York Heart Association was 1.5. Hemodynamic studies revealed excellent results. The mean systolic gradient across the pulmonary valve (delta p) was 14 mm Hg at rest and 31 mm Hg during exercise. The data assessed during exercise show that one cannot truly speak of a "total correction". Right ventricular systolic and enddiastolic pressures were elevated as well as the enddiastolic and endsystolic volumes. Right ventricular ejection fraction was significantly diminished (45%). Our results show that there was no significant difference between the patients with or without an outflow tract patch. Pulmonary insufficiency apparently bears no negative influence on long-term prognosis up to 11 years postoperatively in patients operated for tetralogy of Fallot.
22例21岁以后接受手术的法洛四联症患者在术后平均11年时接受了全面检查。根据纽约心脏协会的标准,平均功能分级为1.5级。血流动力学研究显示结果良好。静息时肺动脉瓣跨瓣收缩期平均压差(δp)为14 mmHg,运动时为31 mmHg。运动期间评估的数据表明,不能真正称之为“完全矫正”。右心室收缩压和舒张末期压力升高,舒张末期和收缩末期容积也升高。右心室射血分数显著降低(45%)。我们的结果表明,有或没有流出道补片的患者之间没有显著差异。在法洛四联症手术患者中,肺动脉瓣关闭不全在术后长达11年的时间里显然对长期预后没有负面影响。