Abe T, Morishita K, Nakanishi K, Kamada K, Komatsu S
Second Department of Surgery, Sapporo Medical University School of Medicine, Japan.
Kyobu Geka. 1994 Jul;47(8):605-11.
Thirty-two of 460 patients (6.9%) who had corrective surgery for tetralogy of Fallot in our institute between January, 1955 and March, 1994 required intracardiac reoperation. The indications for reoperation included residual lesions alone or combination of other lesions. The reoperation consisted of a new patch or direct closure of a residual ventricular septal defect in 28 (73%), reconstruction of a residual pulmonary stenosis in 18 (47%) and pulmonary regurgitation in 6 (16%), repair of tricuspid regurgitation in 11 (29%), recurrent infective endocarditis in 5 (13%), repair of a left ventricle-right atrium communication in 4 (11%). Six patients (19%) had required second reoperation of recurrent infective endocarditis in 3, other three patients required the repair of tricuspid valve disease. There were one operative death (3%) in reoperation and one death (17%) in second reoperation. Three patients (9%) died at follow-up periods of 1-21 years (mean of 9.6 years). Twenty-seven patients (84%) survived operation and 24 (89%) are now in NYHA class I and 3 patients are in class II. Reoperation after correction of tetralogy of Fallot is able to perform with low mortality and with excellent long-term results.
1955年1月至1994年3月期间，在我院接受法洛四联症矫正手术的460例患者中，有32例（6.9%）需要进行心脏内再次手术。再次手术的指征包括单独的残留病变或其他病变的组合。再次手术包括28例（73%）采用新补片或直接闭合残留室间隔缺损、18例（47%）重建残留肺动脉狭窄、6例（16%）处理肺动脉反流、11例（29%）修复三尖瓣反流、5例（13%）治疗复发性感染性心内膜炎、4例（11%）修复左心室-右心房交通。6例患者（19%）需要第二次再次手术，其中复发性感染性心内膜炎3例，另外3例需要修复三尖瓣疾病。再次手术中有1例手术死亡（3%），第二次再次手术中有1例死亡（17%）。3例患者（9%）在1至2年（平均9.6年）的随访期内死亡。27例患者（84%）手术存活，24例（89%）目前心功能为纽约心脏协会（NYHA）I级，3例为II级。法洛四联症矫正术后再次手术能够以低死亡率和良好的长期效果进行。
