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达穆斯-凯-斯坦塞尔手术治疗陶西格-宾心脏畸形或合并主动脉瓣下狭窄的单心室心脏患儿的经验。

Experience with the Damus-Kaye-Stansel procedure for children with Taussig-Bing hearts or univentricular hearts with subaortic stenosis.

作者信息

Lui R C, Williams W G, Trusler G A, Freedom R M, Coles J G, Rebeyka I M, Smallhorn J

机构信息

Division of Cardiovascular Surgery and Cardiology, Hospital for Sick Children, University of Toronto, Ontario, Canada.

出版信息

Circulation. 1993 Nov;88(5 Pt 2):II170-6.

PMID:7693366
Abstract

Anastomosis of the pulmonary artery to the ascending aorta is the essence of a technique for repair of complete transposition proposed by Damus, Kaye, and Stansel. Our Institutional experience with the Damus-Kaye-Stansel procedure (DKS) is limited to 9 children with double-outlet right ventricle and 38 with univentricular heart plus subaortic stenosis. Thirty-eight children (81%) survived the DKS procedure, and there were three late deaths during the mean follow-up of 3.1 years. Five-year survival is 72% (+/- 8%). All six children surviving a DKS and biventricular repair of double-outlet right ventricle have required conduit replacement at a mean interval of 46 months. In the children with univentricular heart, relief of subaortic stenosis with the DKS was successful in all except two. The late function of the semilunar valves is of concern, as 36% of the aortic and 52% of the pulmonary valves have some degree of incompetence.

摘要

肺动脉与升主动脉吻合术是达穆斯、凯伊和斯坦塞尔提出的完全性大动脉转位修复技术的核心。我们机构应用达穆斯 - 凯伊 - 斯坦塞尔手术(DKS)的经验仅限于9例双出口右心室患儿和38例单心室合并主动脉下狭窄患儿。38例患儿(81%)在DKS手术后存活,在平均3.1年的随访期间有3例晚期死亡。5年生存率为72%(±8%)。6例接受DKS和双心室修复的双出口右心室患儿均在平均46个月时需要更换管道。在单心室患儿中,除2例外,DKS解除主动脉下狭窄均获成功。半月瓣的晚期功能令人担忧,因为36%的主动脉瓣和52%的肺动脉瓣存在一定程度的关闭不全。

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