姑息的心房内血流転換手術の遠隔成績 : Palliative Mustard Operation

概要

論文の詳細を見る
A long-term follow-up study on 12 patients following palliative atrial switch operation for complete transposition of the great arteries (d-TGA) associated with pulmonary obstructive vascular disease is presented. The operations were done from 1977 to 1987. Preoperative mean pulmonary vascular resistance was 18.6 ± 8.0 unit. In 5 cases, a ventricular septal defect (VSD) was left open, and in 7 patients VSD was closed with a patch having a central hole, 5 mm in diameter. There were one operative death and three late deaths. Preoperatively all cases were in New York Heart Association functional class III. Mean PaO_2 was 39.7±7.2mmHg. Postoperatively 5 cases were in functional class I and 2 cases in class II. PaO_2 improved to 62.8±7.9 mmHg. In 7 survivers, postoperative Treadmill test was done. The results were as follows : endurance time showed above 90 percentiles of normal in one case, 50 percentiles in one, 25 percentiles in one, 10 percentiles in one, and under 10 percentiles in three. Before and after exercise, arterial oxygen saturation decreased from 95.8 ± 2.6 to 74.5 ± 16.7%. Effective funtion of holed patch was recognized. In postoperative cardiac catheterization, 2 cases who had perforated patch, suggested improved pulmonary hypertension (Pp/Ps : 0.21 and 0.41). Palliative Mustard operation provides excellent symptomatic improvement in all survivors.
日本小児外科学会の論文
1989-04-20