Trusler G A, Miyamura H, Culham J A, Fowler R S, Freedom R M, Williams W G
J Thorac Cardiovasc Surg. 1981 Sep;82(3):398-404.
From 1965 to 1979, 44 patients with Potts and 50 with Waterston aortopulmonary anastomoses were studied angiographically. Fifty-two of the 95 shunts had been banded to limit growth of the anastomosis. Later the internal diameter of the anastomosis was measured in 34 children when the cardiac defect was repaired. On those with late measurements, growth was limited effectively in 17 of the 18 (94%) shunts that had been banded, whereas five of the 16 (31%) unbanded anastomoses grew to more than 6.5 mm internal diameter (p = 0.05). The difference in incidence of moderate or severe stenosis of the pulmonary artery near or at the anastomosis nearly reached a significant level (p = 0.07), occurring in 50% of children with banded shunts in comparison with 31% of children with unbanded shunts. Mean pulmonary artery pressures were obtained in 77 children, 36 with potts and 41 with Waterston shunts. Six of 43 with a banded anastomosis had a mean pulmonary artery pressure above 30 mm Hg, the highest being 43 mm Hg. Seven of 34 children with an unbanded anastomosis had a mean pulmonary artery pressure of 30 mm Hg or more, and in three the pressures were over 50mm Hg. In unbanded Potts or Waterston shunts the incidence of pulmonary artery stenosis was 60%. This high incidence discourages the use of these aortopulmonary anastomoses if other shunts can be constructed safely and effectively.
1965年至1979年期间，对44例接受波特斯手术和50例接受沃斯顿主动脉肺动脉吻合术的患者进行了血管造影研究。95例分流术中的52例已进行束带处理以限制吻合口生长。后来，在34名儿童修复心脏缺陷时测量了吻合口的内径。在那些进行了后期测量的病例中，18例接受束带处理的分流术中，有17例（94%）吻合口生长得到有效限制，而16例未束带处理的吻合口中，有5例（31%）内径增长超过6.5毫米（p = 0.05）。吻合口附近或吻合处肺动脉中度或重度狭窄的发生率差异几乎达到显著水平（p = 0.07），接受束带分流术的儿童中发生率为50%，而未束带分流术的儿童中为31%。对77名儿童进行了平均肺动脉压测量，其中36例接受波特斯手术，41例接受沃斯顿分流术。43例接受束带吻合术的患者中有6例平均肺动脉压高于30毫米汞柱，最高为43毫米汞柱。34例未束带吻合术的儿童中有7例平均肺动脉压为30毫米汞柱或更高，3例超过50毫米汞柱。在未束带的波特斯或沃斯顿分流术中，肺动脉狭窄的发生率为60%。如果能够安全有效地构建其他分流术，这种高发生率不鼓励使用这些主动脉肺动脉吻合术。
