肺高血圧を伴う乳児期開心術症例の検討

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A total of 36 patients aged under 11 months (4 weeks-11 months) with pulmonary hypertension underwent open-heart surgery between April, 1986 and March, 1990. We assessed the recovery of A-aDO_2 until 48 hours after surgery and the improvement of pulmonary artery systolic pressur (PAPs) at 2 weeks and 1 year after surgery. Anomalies of those patients were : ventricular septal defect (VSD) in 12, VSD with atrial septal defect (ASD) in 9, VSD with coarctation of aorta in 2 (Group VSD, n = 22), ASD in 4 (Group ASD), total anomalous pulmonary venous return (TAPVR) in 9 (Group TPR). And VSD and TAPVR groups were divided into each two subgroups : VSD associated with Down syndrome (Group V-D), or not (Group V-N) ;TAPVR aged under 8 weeks (Group T-1), over 9 weeks (Group T-2). In A-aDO_2, group V-D and T-2 showed a significant delay of the recovery though all groups recoverd to normal levels before 48 hours. In PAPs at 2 weeks after surgery, group V-D and T-2 showed high levels (43.5 ±12.6, 47.7 ± 13.6mmHg, respectively) though all groups had a significant decrease compared to preoperative levels. At 1 year, the PAPs in group V-D remained at high levels (56.6±9.0mmHg), and in group T-2 decreased gradually (34.6±3.0mmHg) We concluded that corrective surgery for VSD with Down syndrome and TAPVR should be performed in the early stage because the pulmonary vascular disease in those patients might be produced in early infancy.
日本小児外科学会の論文
1992-04-20

肺高血圧を伴う乳児期開心術症例の検討

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