Capelli H, Ross D, Somerville J
Am J Cardiol. 1982 Jun;49(8):1979-83. doi: 10.1016/0002-9149(82)90218-1.
Data on 18 patients, aged 12 to 42 years, with documented aortic regurgitation and tetrad of Fallot or pulmonary atresia with ventricular septal defect were reviewed. In two patients, aortic regurgitation was caused by surgical repair but in the others it was present before operation. There was increased volume overload from a long-standing surgical shunt (8 to 30 years' duration) or congenital systemic collateral vessels in 14. Six patients with a history of infective endocarditis had aortic cusp perforations. Failure to detect the presence of aortic regurgitation before radical repair in six patients contributed to operative problems and postoperative morbidity and mortality. Aortic valve surgery was performed in 13 patients. Aortic regurgitation is an acquired complication that should be specifically excluded by routine retrograde ascending aortography in all adolescents or adults with tetrad of Fallot or pulmonary atresia with ventricular septal defect. Earlier radical repair in the first decade of life may prevent the complication.
回顾了18例年龄在12至42岁之间、有主动脉反流记录且患有法洛四联症或室间隔缺损合并肺动脉闭锁的患者的数据。2例患者的主动脉反流由手术修复引起，其他患者则在手术前就已存在。14例患者因长期存在的外科分流（持续时间为8至30年）或先天性体循环侧支血管导致容量负荷增加。6例有感染性心内膜炎病史的患者存在主动脉瓣叶穿孔。6例患者在根治性修复前未检测到主动脉反流，这导致了手术问题以及术后的发病率和死亡率。13例患者接受了主动脉瓣手术。主动脉反流是一种后天性并发症，对于所有患有法洛四联症或室间隔缺损合并肺动脉闭锁的青少年或成年人，应通过常规逆行升主动脉造影术专门排除该并发症。在生命的第一个十年进行早期根治性修复可能预防该并发症。
