Mair D D, Ritter D G, Danielson G K, Wallace R B, McGoon D C
Circulation. 1977 Apr;55(4):641-7. doi: 10.1161/01.cir.55.4.641.
In 15 of 126 (12%) patients with truncus arteriosus who were catheterized at the Mayo Clinic from 1967 through 1975, natural agenesis of one pulmonary artery was present. Ten truncus patients with either natural or acquired absence of one pulmonary artery have undergone definitive operation. The criteria for operability, based on a calculation of pulmonary resistance, are different in patients with single pulmonary artery than in patients with two pulmonary arteries. Study revealed that, if the calculated pulmonary resistance in the patient with single pulmonary artery is halved, this new value provides a more reliable assessment of the reactivity of the pulmonary arteriolar bed than does the total calculated pulmonary resistance value. Follow-up information suggests that the patient with single pulmonary artery may be at potentially high risk of continued progression of pulmonary vascular disease after surgical correction, possibly because of the postoperative obligatory increased flow through the single pulmonary arteriolar bed as a result of the entire cardiac output passing through it. Surgical correction of truncus arteriosus during infancy, before significant pulmonary vascular disease has developed, appears to be particularly desirable in this subgroup of patients with single pulmonary artery.
1967年至1975年在梅奥诊所接受心导管检查的126例共同动脉干患者中，有15例（12%）存在一侧肺动脉先天性缺如。10例一侧肺动脉先天性或后天性缺如的共同动脉干患者接受了根治性手术。基于肺阻力计算的手术可操作性标准，单肺动脉患者与双肺动脉患者有所不同。研究表明，对于单肺动脉患者，若将计算出的肺阻力减半，这一新值比计算出的肺阻力总值能更可靠地评估肺小动脉床的反应性。随访信息提示，单肺动脉患者在手术矫正后，可能因整个心输出量都流经单肺小动脉床，导致术后流经该血管床的血流量必然增加，从而存在肺血管疾病持续进展的潜在高风险。对于这一单肺动脉亚组患者，在婴儿期且尚未发生严重肺血管疾病时进行共同动脉干的手术矫正似乎尤为可取。
