Bonnetts P L, Goldberg S J, Copeland J G
Department of Pediatrics and Surgery, Steele Memorial Children's Research Center, Tucson, Arizona.
Am J Cardiol. 1994 Dec 1;74(11):1157-60. doi: 10.1016/0002-9149(94)90471-5.
Experience with 43 consecutive cases of isolated (except for patent ductus) atrioventricular (AV) defects treated surgically at University Medical Center in Tucson, Arizona, were reviewed to determine occurrence and amount of postoperative left AV valve regurgitation. Patients initially evaluated at ages 1 day to 59 months were included, 32 of whom had Down's syndrome and 11 of whom had normal chromosomes. Age at repair ranged from 1 month to 171 months; 70% of patients had repair at < 16 months of age. Mean follow up was 7.1 years. Nine patients died, 8 of whom had Down's syndrome. Left AV valve regurgitation was absent or mild in 69% of patients who survived the perioperative period; however, very early repair (age < or = 4 months) was associated with significantly greater probability of moderate or severe left AV valve regurgitation than that seen in patients who had repair after that age. These data suggest that left AV valve regurgitation after repair of AV defects is usually not clinically significant, but patients in this series who underwent operation very early (age < or = 4 months) were at the highest risk for significant left AV valve regurgitation.
回顾了亚利桑那州图森市大学医学中心连续43例孤立性(除动脉导管未闭外)房室(AV)缺损手术治疗的病例,以确定术后左房室瓣反流的发生率和程度。纳入了最初在1天至59个月龄时接受评估的患者,其中32例患有唐氏综合征,11例染色体正常。修复时的年龄范围为1个月至171个月;70%的患者在16个月龄之前进行了修复。平均随访7.1年。9例患者死亡,其中8例患有唐氏综合征。在围手术期存活的患者中,69%的患者不存在或仅有轻度左房室瓣反流;然而,与该年龄之后进行修复的患者相比,极早期修复(年龄≤4个月)与中度或重度左房室瓣反流的可能性显著增加相关。这些数据表明,房室缺损修复术后的左房室瓣反流通常在临床上不具有显著意义,但在本系列中,极早期(年龄≤4个月)接受手术的患者发生显著左房室瓣反流的风险最高。