Gutgesell H P, Garson A, McNamara D G
Am J Cardiol. 1979 Jul;44(1):96-100. doi: 10.1016/0002-9149(79)90256-x.
To determine the prognosis for the newborn with transposition of the great arteries, the clinical course of 112 consecutive neonates with dextrotransposition was reviewed. Patients were managed with balloon atrial septostomy at initial cardiac catheterization, palliative operation if needed in the 1st year of life and Mustard's intraatrial baffle repair. The 1st month of life was the period of greatest risk (8 percent mortality rate). Between balloon septostomy and baffle repair, 14 of 103 patients at risk (14 percent) either died or had a cerebrovascular accident. The mortality rate at baffle repair was 14 percent (10 deaths in 71 patients), and there were 3 late postoperative deaths. Actuarial analysis of the data indicates that with this plan of management, approximately 50 percent of newborns with transposition of the great arteries will survive 5 years with excellent function and an additional 15 to 20 percent will survive with one or more medical handicaps.
为了确定大动脉转位新生儿的预后，我们回顾了112例连续的右旋大动脉转位新生儿的临床病程。患者在初次心导管检查时接受球囊房间隔造口术治疗，在1岁以内如有需要则进行姑息性手术，以及Mustard心房内挡板修复术。出生后的第1个月是风险最高的时期（死亡率为8%）。在球囊造口术和挡板修复术之间，103例有风险的患者中有14例（14%）死亡或发生脑血管意外。挡板修复术的死亡率为14%（71例患者中有10例死亡），术后还有3例晚期死亡。对数据的精算分析表明，采用这种治疗方案，大约50%的大动脉转位新生儿将存活5年且功能良好，另有15%至20%的患者将存活但伴有一种或多种医学上的缺陷。
