Dobell A R, Bloss R S, Gibbons J E, Collins G F
J Thorac Cardiovasc Surg. 1981 Jun;81(6):916-20.
Case histories of 50 consecutive infants and children ith congenital valvular aortic stenosis treated at The Montreal Children's Hospital during the past 16 years were reviewed in order to determine the efficacy of the initial treatment as well as the long-term results. The operative technique employed was to incise fused commissures out almost to the anulus without causing aortic insufficiency, but often the accomplishment was limited by valve anatomy or cusp dysplasia. Six of the seven operative deaths occurred in infants. Eight to 16 year follow-up on the first 25 survivors revealed one late death, four "good" results, five aortic valve replacements, and three second valvotomies. Ten patients have recurrent aortic stenosis and two have moderate aortic insufficiency. Aortic valvotomy is a palliative operation, and about a third of the children operated upon will require a second operation within 10 years.
回顾了蒙特利尔儿童医院在过去16年中连续收治的50例先天性瓣膜性主动脉狭窄婴幼儿及儿童的病历，以确定初始治疗的疗效及长期结果。所采用的手术技术是在不造成主动脉瓣关闭不全的情况下，几乎切至瓣环处切开融合的瓣叶交界，但通常这一操作会受到瓣膜解剖结构或瓣叶发育异常的限制。7例手术死亡中有6例发生在婴儿。对最初25名幸存者进行8至16年的随访发现，有1例晚期死亡、4例“良好”结果、5例行主动脉瓣置换术以及3例行二次瓣膜切开术。10例患者出现复发性主动脉狭窄，2例有中度主动脉瓣关闭不全。主动脉瓣切开术是一种姑息性手术，约三分之一接受手术的儿童在10年内需要再次手术。
