Zafra Anta M, Moreno Granado F, Calvo Rey C, Fernández Ruiz A, Rey del Castillo C, Cordovilla Zurdo G, Alvarez Díaz F
Servicio de Cardiología Pediátrica, Hospital Infantil La Paz, Madrid.
An Esp Pediatr. 1993 Mar;38(3):213-9.
This retrospective study and review of the literature was undertaken to assess the long term results of valvotomy in congenital aortic stenosis (AS). One hundred and seven patients, aged between 14 days and 15 years (mean: 6.2 years), were operated on between 1966 and 1989. Thirty-three cases had valvular AS, 48 discrete subvalvular AS, 10 supravalvular AS and 16 combined AS. Thirty-three patients had associated cardiac anomalies. The surgical mortality was 6.5% (3.5% in children over 2 years of age). Three patients were lost. Ninety-seven patients had a follow-up period between 6 months and 16 years (mean: 5.4 years) with an actuarial survival of 95% at the age of 15 years. There were adverse events in 39 patients: AS, aortic regurgitation, bacterial endocarditis, third-degree heart block. Thirteen patients required re-operation and 4 balloon valvuloplasty; the late mortality was 5%. We conclude that this surgery has a low surgical mortality, but must be considered as palliative in most cases.
本回顾性研究及文献综述旨在评估先天性主动脉瓣狭窄(AS)行瓣膜切开术的长期效果。1966年至1989年间,对107例年龄在14天至15岁(平均6.2岁)的患者进行了手术。其中33例为瓣膜性AS,48例为局限性瓣下AS,10例为瓣上AS,16例为合并性AS。33例患者伴有心脏异常。手术死亡率为6.5%(2岁以上儿童为3.5%)。3例患者失访。97例患者随访时间为6个月至16年(平均5.4年),15岁时精算生存率为95%。39例患者出现不良事件:AS、主动脉瓣反流、细菌性心内膜炎、三度房室传导阻滞。13例患者需要再次手术,4例接受球囊瓣膜成形术;晚期死亡率为5%。我们得出结论,该手术手术死亡率低,但在大多数情况下必须视为姑息性手术。