在4岁以下的患者中修改了Fontan程序
J M Pearl1, H Laks, D C Drinkwater
1Department of Surgery, University of California, Los Angeles Medical School.
Circulation
|November 1, 1992
概括
修改后的Fontan程序对4岁以下的儿童是安全有效的,提供了改善的临床结果. 选择患者的早期干预可以保护肺血管床并保持心室功能.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 儿科心脏病重症监护 儿科心脏病重症监护
背景情况:
- 在幼儿 (<4岁) 中,修改后的Fontan程序最初具有可变的成功率和高死亡率.
- 最近的进展已经改善了修改后的Fontan手术在年轻儿科患者群体的结果.
- 早期的Fontan缓解提供了诸如肺血管床保护和保持心室功能等好处.
研究的目的:
- 评估修改后的Fontan手术在4岁以下的患者的安全性和有效性.
- 为了比较这个儿科队列中早期和晚期的结果.
主要方法:
- 在1982年至1991年5月期间,对90名4岁以下的患者进行了回顾性审查,这些患者接受了修改后的Fontan手术.
- 患者的诊断包括三腹缩症,单心室,肺缩症和左心脏低可塑性综合征.
- 在21例患者中使用可调节性心房切除术 (ASD).
主要成果:
- 早期死亡率为8.9% (8/90),相当于Fontan整体早期死亡率的7.4%.
- 在2岁以下的患者中 (n=30),早期死亡率为6.7% (2/30).
- 平均38个月的随访时间显示,有3例晚期死亡 (3.7%) 和1例心脏移植.
结论:
- 修改后的Fontan手术可以安全地在4岁以下的患者中进行,并产生良好的临床结果.
- 建议在6个月以上的婴儿进行早期的Fontan息,这些婴儿有渐进的蓝色和有利的血液动力学.
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