ファロー四徴症根治手術症例の検討 : 小児群と年長群の心機能,不整脈および遠隔期成績について

概要

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Fifty-six consecutive patients underwent successfully total correction of tetralogy of Fallot between November, 1981 and December, 1989. There was no operative death, but two patients died during follow-up period. Thirty of 56 patients who had postoperative cardiac catheterization at early (one month) and late (60 months) after surgery were comprised of 16 children (under 15 years : mean 10.4±4.9) and 14 adults (over 16 years : mean 21.8±8.1). The mean values of cardiac index (CI), PA diastolic pressure, LV endo-diastolic volume and heart rate at one month, both CI and LV ejection fraction at 60 months were significantly higher in children than in adults. Incidence of the late arrhythmias defected by Holter ECG was significantly higher in adults than in children. Fifty-one of 54 patients (91%) who survived after surgery are now in NYHA functional class I, but incidences of the late deaths (2 patients) and the re-surgery (3/4) were significantly higher in adults than in children. These early and late results indicated that correction of tetralogy of Fallot should be carried out in children under 15 years of age.
日本小児外科学会の論文
1991-10-20