修改后的Fontan手术对低可塑性左心综合征的结果和评估
P E Farrell1, A C Chang, K A Murdison
1Division of Cardiology, Children's Hospital of Philadelphia, PA 19104.
Circulation
|January 11, 1992
概括
对于低可塑性左心综合征 (HLHS) 修改后的Fontan手术的生存率与其他复杂的心脏病状况相比较. 作为系统性心室的右心室在HLHS幸存者中显示出优异的中间结果.
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
- 心脏生理学 心脏生理学
背景情况:
- 该研究回顾了76名患有低可塑性左心综合征 (HLHS) 的患者的结果,这些患者接受了经过修改的Fontan手术.
- 5个月至6岁的患者在1984年至1989年期间在Fontan手术之前接受了息性手术.
研究的目的:
- 评估HLHS患者修改后的Fontan手术的结果.
- 评估使用右心室作为HLHS幸存者的全身心室的中间结果.
主要方法:
- 经过修改的Fontan手术包括过心脏阻塞 (n=10) 或下静脉空腔阻塞与肺动脉增大 (n=66).
- 精算生存率计算在1个月,1年,2年和4年.
- 在幸存者身上进行了术后心脏导管,以评估血液动力学值.
主要成果:
- 精算生存率为74% (1个月),58% (12个月),56% (2年) 和52% (4年).
- 在25名穿透导管的幸存者中,血液动力学值显示心脏指数为2.8 +/- 0.6 l/min/m2,右动脉压为11 +/- 2 mm Hg.
- 没有观察到显著的三管或本源肺 insufficiency.
结论:
- 对于HLHS,Fontan手术后的存活率与其他复杂的先天性心脏病变相当.
- 作为系统性心室的右心室在经历了重建和Fontan手术的HLHS患者中产生了出色的中间结果.
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