Spiegelenberg S R, Hutter P A, van de Wal H J, Hitchcock J F, Meijboom E J, Harinck E
Pediatric Heart Centre, Wilhelmina Children's Hospital, University Hospital Utrecht, The Netherlands.
Eur J Cardiothorac Surg. 1995;9(1):7-10; discussion 10-1. doi: 10.1016/s1010-7940(05)80041-7.
Seventy-six patients were studied after arterial switch operation (ASO) between May 1977 and February 1992. Pulmonary artery reconstruction was initially performed by: conduit interposition in 5 patients, direct main pulmonary artery anastomosis and button patches in 60 patients, and pantaloon-like patch repair in 11 patients. Pulmonary stenosis developed in 17 patients (22%), requiring a total of 26 late re-interventions. Re-intervention was required in four out of five patients operated with pulmonary artery conduits, 11 out of 60 with a button patch repair and 2 out of 11 following pantaloon-type repair. In this series pulmonary artery stenosis (PS) involving the pulmonary valve occurred in 9/17 patients. Involvement of the pulmonary valve was related to the technique of pulmonary artery reconstruction. In these patients surgery is necessary. Balloon angioplasty can be a valuable tool when the stenosis is more distal. The incidence of PS was not influenced by the type of reconstruction or the use of Lecompte's maneuver.
1977年5月至1992年2月期间，对76例接受动脉调转术（ASO）的患者进行了研究。最初进行肺动脉重建的方式如下：5例患者采用管道植入，60例患者采用直接主肺动脉吻合和纽扣补片，11例患者采用裤形补片修复。17例患者（22%）出现了肺动脉狭窄，共需要进行26次后期再次干预。在接受肺动脉管道手术的5例患者中有4例需要再次干预，在采用纽扣补片修复的60例患者中有11例，在裤形补片修复后的11例患者中有2例。在该系列中，17例患者中有9例发生了累及肺动脉瓣的肺动脉狭窄（PS）。肺动脉瓣受累与肺动脉重建技术有关。对于这些患者，手术是必要的。当狭窄部位更靠远端时，球囊血管成形术可能是一种有价值的手段。PS的发生率不受重建类型或是否使用Lecompte手法的影响。
