Rigler B, Kraft-Kinz J, Hermann W, Stenzl W, Tscheliessnigg K H, Dacar D, Hiotakis K, Beitzke A, Metzler W
Langenbecks Arch Chir. 1980;351(1):51-61. doi: 10.1007/BF01241930.
Between 1970 and 1978 135 infants with congenital malformations underwent operations due to congestive heart failure, progressive pulmonary hypertension, and severe cyanosis. Of them, 63% were acyanotic; 68% of all operations became necessary during the first 6 months of life. The late mortality rate was 5% and the hospital mortality rate 17%. A remarkably higher operative risk was found during the first 6 months of life. Ligation of patent ductus arteriosus as the most common lesion was done with a mortality rate of 2.5% which is comparable to the risk of late repair in childhood. Pulmonary artery banding could be performed in all acyanotic malformations with a mortality rate of 17% and of 12.5% in isolated VSD (including debanding and VSD closure in several cases). Coarctation of the aorta was corrected with a overall mortality rate of 26%. Because of a recurrence rate of 20%, the authors think that operations are only indicated in symptomatic cases of coarctation. In complex cyanotic malformations, a higher operative risk was observed in both pulmonary artery banding (38%) and shunt operations (44%). If surgical treatment is necessary, the earlier, the better.
1970年至1978年间，135例先天性畸形婴儿因充血性心力衰竭、进行性肺动脉高压和严重紫绀接受了手术。其中，63%为非紫绀型；68%的手术在出生后的前6个月进行。晚期死亡率为5%，医院死亡率为17%。在出生后的前6个月，手术风险明显更高。作为最常见病变的动脉导管未闭结扎术的死亡率为2.5%，这与儿童期晚期修复的风险相当。所有非紫绀型畸形均可进行肺动脉环扎术，其死亡率为17%，单纯室间隔缺损（包括在某些病例中解除环扎和室间隔缺损闭合）的死亡率为12.5%。主动脉缩窄矫正术的总死亡率为26%。由于复发率为20%，作者认为手术仅适用于有症状的主动脉缩窄病例。在复杂的紫绀型畸形中，肺动脉环扎术（38%）和分流手术（44%）的手术风险均较高。如果有必要进行手术治疗，越早越好。
