Gazzaniga A B, Lamberti J J, Siewers R D, Sperling D R, Dietrick W R, Arcilla R A, Replogle R L
J Thorac Cardiovasc Surg. 1976 Sep;72(3):357-63.
A new arterial prosthesis made of polytetrafluoroethylene (OTFE) was evaluated in 10 infants with complex cyanotic congenital heart disease. All grafts used were 4 mm. in diameter and varied in length from 0.8 to 6 cm. The grafts were anastomosed to the main pulmonary artery or its bifurcation in 8 infants and to the right and left pulmonary arteries in one each. There were two early deaths, one of which was related to shunt failure. The advantages of a shunt to the main pulmonary artery are obvious, and the intraoperative procedure is facilitated with the prosthesis. Follow-up averages 9 months in the 8 survivors, and the patients have nearly doubled their preoperative weight. A shunt murmur is present in each case and the children have mild-to-moderate cyanosis at rest. Repeat aortograms in 2 patients, 8 and 10 months postoperatively, show a smooth graft without luminal narrowing. The aortic oxygen saturations were 73 per cent. The PTFE graft and/or anastomoses will not grow with the growth of the child and therefore may not accommodate growth by increased flow. This may prove to be a limiting factor in its long-term use in fants. We reserve the use of these grafts for infants with complex cyanotic defects undergoing emergency surgery or in older children in whom a conventional shunt is not possible or a previous shunt has failed.
一种由聚四氟乙烯（OTFE）制成的新型动脉假体在10例患有复杂青紫型先天性心脏病的婴儿中进行了评估。所有使用的移植物直径均为4毫米，长度从0.8厘米到6厘米不等。8例婴儿的移植物与主肺动脉或其分叉处吻合，另外各有1例与左右肺动脉吻合。有2例早期死亡，其中1例与分流失败有关。向主肺动脉分流的优点显而易见，使用该假体可简化手术过程。8名幸存者的随访平均时间为9个月，这些患儿的术前体重几乎增加了一倍。每例均有分流杂音，患儿静息时存在轻度至中度青紫。2例患者在术后8个月和10个月进行的重复主动脉造影显示移植物通畅，无管腔狭窄。主动脉血氧饱和度为73%。聚四氟乙烯移植物和/或吻合口不会随着患儿生长而生长，因此可能无法通过增加血流来适应生长。这可能被证明是其在婴儿长期使用中的一个限制因素。我们仅将这些移植物用于接受急诊手术的复杂青紫型缺陷婴儿，或用于无法进行传统分流术或既往分流术失败的大龄儿童。
