Midgley F M, Galioto F M, Shapiro S R, Perry L W, Scott L P
Ann Thorac Surg. 1980 Aug;30(2):151-9. doi: 10.1016/s0003-4975(10)61233-7.
Twenty-nine patients at out institution have undergone repair of complete atrioventricular canal since 1969. There were 3 operative and 5 late deaths, 4 of which were of infectious etiology. Age at operation ranged from 2 months to 12 years (mean, 50 months). Weight ranged from 3.6 kg to 30 kg (mean, 12 kg). Before repair, catheterization studies revealed pulmonary hypertension in all patients with unobstructed pulmonary arteries. Pulmonary to systemic flow ratio ranged from 1.5 to 10.6 (mean, 3.5). Pulmonary vascular resistance (PVR) ranged from 0.7 to 21.7 (mean, 5.3) Wood units/m2. At repair, 14 patients had Rastelli type A anatomy, 14 had type C, and 1 patient had a variant with crossing chordae and double-outlet right ventricle (DORV). Postoperative catheterization has been done in 16 patients 2 months to 8 years (mean, 30 months) after repair. One patient had residual ventricular shunting and later underwent successful repair. A 2-year-old patient had severe mitral regurgitation and died following mitral valve replacement. One patient required a permanent pacemaker. The 21 surviving patients have been followed from 7 months to 10 years 7 months and have excellent hemodynamic status. Long-term studies are needed to assess the ultimate effect on patients with high PVR.
自1969年以来，我院有29例患者接受了完全性房室通道修补术。手术死亡3例，晚期死亡5例，其中4例死于感染性病因。手术年龄从2个月至12岁不等（平均50个月）。体重从3.6 kg至30 kg不等（平均12 kg）。修补术前，心导管检查显示所有肺动脉无梗阻的患者均有肺动脉高压。肺循环与体循环血流量比值从1.5至10.6不等（平均3.5）。肺血管阻力（PVR）从0.7至21.7不等（平均5.3）伍德单位/m²。修补时，14例患者为Rastelli A型解剖结构，14例为C型，1例为交叉腱索和右心室双出口（DORV）变异型。16例患者在修补术后2个月至8年（平均30个月）进行了术后心导管检查。1例患者有残余心室分流，后来成功接受了修补。1例2岁患者有严重二尖瓣反流，在二尖瓣置换术后死亡。1例患者需要永久性起搏器。21例存活患者的随访时间为7个月至10年7个月，血流动力学状态良好。需要进行长期研究以评估对高PVR患者的最终影响。
