Shohtsu A, Takeuchi S, Inoue T
Jpn Circ J. 1976 Jun;40(6):629-32. doi: 10.1253/jcj.40.629.
Prior to 1970, 35 patients of VSD with Pp/Ps of 0.8 or more were subjected to primary closure of the defect, resulting in 11 operative deaths. Since 1971, however, the surgical results have been much improved and 29 such patients were operated on without death. It has been considered the optimal time of elective closure of VSD with severe pulmonary hypertension is at the age of 1 to 3 years, however, if decrease in apical diastolic rumble and heart size are found, earlier operation less than one year of age is to be scheduled. Surgical indications and results of PDA, PDA with VSD, and ASD associated with severe pulmonary hypertension were also discussed.
1970年以前，35例室间隔缺损（VSD）且肺血管阻力与体循环阻力比值（Pp/Ps）为0.8或更高的患者接受了缺损的一期闭合手术，导致11例手术死亡。然而，自1971年以来，手术结果有了很大改善，29例此类患者接受手术且无死亡。一般认为，对于伴有严重肺动脉高压的室间隔缺损，择期闭合的最佳时间是1至3岁，然而，如果发现心尖舒张期隆隆样杂音和心脏大小减小，则应安排在1岁以内进行更早的手术。还讨论了动脉导管未闭（PDA）、合并室间隔缺损的动脉导管未闭以及合并严重肺动脉高压的房间隔缺损（ASD）的手术指征和结果。
