主页 > 医学文档 >
【文摘发布】Taussig-Bing畸形大动脉调转术后右室
Title: Right ventricular outflow tract obstruction after arterial switch operation for the heart.
Author: Sinzobahamvya N, Blaschczok HC, Asfour B, Arenz C, Jussli MJ, Schindler E, Photiadis J, Urban AE.
.Resource: Eur J Cardiothorac Surg. 2007 Mar 3
Abstract: Objective: Incidence of right ventricular outflow tract obstruction (RVOTO) may be suspected to be higher after arterial switch operation (ASO) for Taussig-Bing heart than after ASO for transposition of the great arteries (TGA), as Taussig-Bing anomaly is frequently associated with aortic arch obstruction and subvalvular aortic stenosis. We evaluated the risk to develop RVOTO after ASO for Taussig-Bing heart. Methods: The 34 Taussig-Bing cases who underwent ASO from 1984 to 2005 were reviewed. RVOTO was defined as peak echo-gradient >/=30mmHg across right ventricular outflow tract. Kaplan-Meier method was used to estimate time-related events. Results: Subaortic stenosis was resected in 25 patients, 20 of whom (80%: 20/25) were discharged from hospital free from RVOTO. There was one early death: 2.9% mortality. Three patients died late. Actuarial survival was 85.1%+/-7.0% from 54 month onwards. Eleven survivors (36.7%: 11/30) experienced postoperative RVOTO. Obstruction was seen in 82% (9/11) of cases at subvalvular and/or valvular level. Surgery (n=4) or percutaneous intervention (n=2) was required in six patients. Patients discharged from hospital with RVOTO (n=8) were more likely to undergo reintervention for RVOTO (p=0.026). Freedom from reintervention for RVOTO decreased rapidly in the first two years to 86.5+/-6.3%, slowly thereafter (80.4+/-8.4% at year 7) and stabilized at 70.3+/-11.9% from year 11 on. Risk for RVOTO occurrence was 23.5+/-7.3% early after repair and progressively increased to level out at 53.6+/-11% at year 11. Patients who underwent subaortic resection were more likely (p=0.023) to be free from RVOTO occurrence or development. In the period under review, for patients who underwent ASO for simple (n=355) and complex (n=92) TGA, reoperation rate for neopulmonary stenosis was 0.3% (1/355) and 5.4% (5/92), respectively, to be compared to 11.8% (4/34) RVOTO rate of reoperation for Taussig-Bing heart in this study. Conclusions: Postoperative right-sided obstruction occurs more frequently after ASO repair of Taussig-Bing heart than after TGA arterial switching, leading to higher reintervention rate. Resection of the commonly associated subaortic stenosis often prevents RVOTO development.
PMID: 17339117 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Title: Right ventricular outflow tract obstruction after arterial switch operation for the heart
题目：心脏动脉转位术后右室流出道梗阻
作者: Sinzobahamvya N, Blaschczok HC, Asfour B, Arenz C, Jussli MJ, Schindler E, Photiadis J, Urban AE.
来源: Eur J Cardiothorac Surg. 2007 Mar 3
Abstract: Objective: Incidence of right ventricular outflow tract obstruction (RVOTO) may be suspected to be higher after arterial switch operation (ASO) for Taussig-Bing heart than after ASO for transposition of the great arteries (TGA), as Taussig-Bing anomaly is frequently associated with aortic arch obstruction and subvalvular aortic stenosis
摘要
目的：Taussig-Bing 心脏畸形行心脏转位术（ASO)比大动脉转位行心脏转位术后发生右室流出道梗阻（RVOTO)的发生率可能更高，因为Taussig-Bing畸形解剖结构上常伴有主动脉弓梗阻及主动脉瓣下狭窄。
We evaluated the risk to develop RVOTO after ASO for Taussig-Bing heart. Methods: The 34 Taussig-Bing cases who underwent ASO from 1984 to 2005 were reviewed. RVOTO was defined as peak echo-gradient >/=30mmHg across right ventricular outflow tract. Kaplan-Meier method was used to estimate time-related events
作者评价Taussig-Bing 心脏畸形行心脏转位术（ASO)后发生 RVOTO 的危险。
方法：综述了从1984年到2005年34例行ASO的Taussig-Bing畸形的病例。RVOTO 定义为过右室流出道的超声心动图梯度峰值>/=30mmHg 。用卡普兰－迈耶曲线方法评价时间相关事件。
Results: Subaortic stenosis was resected in 25 patients, 20 of whom (80%: 20/25) were discharged from hospital free from RVOTO. There was one early death: 2.9% mortality. Three patients died late. Actuarial survival was 85.1%+/-7.0% from 54 month onwards. Eleven survivors (36.7%: 11/30) experienced postoperative RVOTO. Obstruction was seen in 82% (9/11) of cases at subvalvular and/or valvular level.
结果：25位患者主动脉瓣下狭窄行切除术，其中20人（80％: 20/25) 解除了RVOTO后出院。仅有一例死亡：死亡率为2.9％。三例出院之后死亡。出院后54个月精确存活率为85.1%+/-7.0%。11位存活者(36.7%: 11/30)出现了术后RVOTO，其中82% (9/11)的病例梗阻发生于瓣膜下和/或瓣膜水平。
Surgery (n=4) or percutaneous intervention (n=2) was required in six patients. Patients discharged from hospital with RVOTO (n=8) were more likely to undergo reintervention for RVOTO (p=0.026). Freedom from reintervention for RVOTO decreased rapidly in the first two years to 86.5+/-6.3%, slowly thereafter (80.4+/-8.4% at year 7) and stabilized at 70.3+/-11.9% from year 11 on.
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-01-07 15:46
医学,生命科学网