Miyaji K, Shimada M, Sekiguchi A, Ishizawa A, Isoda T, Tsunemoto M
Department of Cardiovascular Surgery, National Children's Hospital, Tokyo, Japan.
Ann Thorac Surg. 1995 Dec;60(6):1762-4. doi: 10.1016/0003-4975(95)00764-4.
Between 1982 and 1984, we successfully performed "one and a half ventricular repair" using a Glenn shunt for 3 patients with pulmonary atresia with intact ventricular septum. Here we review the 10-year follow-up results.
In these patients, the preoperative Z scores of the tricuspid valve diameters ranged from -5.2 to -6.5. Right ventricular outflow tract reconstruction combined with a Glenn shunt were performed in all patients. Cardiac catheterization was done at least 10 years post-operatively.
All 3 patients have maintained New York Heart Association functional class I status for more than 10 years. Angiography in 2 patients confirms sufficient left pulmonary artery pressure with pulsatile blood flow and good right ventricular contraction. A pulmonary arteriovenous fistula has developed in 1 patient.
Although the lower limits of the tricuspid valve diameter for "one and a half ventricular repair" using a cavopulmonary shunt have not yet been determined, we successfully performed this procedure in 3 patients with severely hypoplastic right ventricles and tricuspid valve diameter Z scores of less than -5.0. The results up to 10 years postoperatively are acceptable.
1982年至1984年间，我们成功地对3例室间隔完整的肺动脉闭锁患者采用格林分流术进行了“一个半心室修复”。在此我们回顾10年的随访结果。
这些患者术前三尖瓣直径的Z值范围为-5.2至-6.5。所有患者均进行了右心室流出道重建并联合格林分流术。术后至少10年进行了心导管检查。
所有3例患者10多年来一直保持纽约心脏协会心功能I级状态。2例患者的血管造影证实左肺动脉压力足够，有搏动性血流，右心室收缩良好。1例患者出现了肺动静脉瘘。
尽管采用腔肺分流术进行“一个半心室修复”时三尖瓣直径的下限尚未确定，但我们成功地对3例右心室严重发育不良且三尖瓣直径Z值小于-5.0的患者实施了该手术。术后长达10年的结果是可以接受的。
