ファロー四徴症の二次的根治手術に関する臨床的研究

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One hundred and eleven cases of tetralogy of Fallot after palliative operations were meticulously evaluated and the following conclusions were obtained : 1) Indications for palliative operation a) Infants and children less than 4 years of age or body weight less than 15 kg. b) Patients with severely limited exercise tolerance or hemoglobin level more than 18.0 g/dl with repeated anoxic spells. c) Patients whose pulmonary to aortic diameter ratio in angiogram less than 0.3 or with diffuse hypoplastic pulmonary artery. d) Patients with hypoplasic left ventricle (RV1+ SV6/SV1+RV6 ≧ 2.0) e) Patients associated with another cardiac anomalies such as abnormal distribution of right coro-nary artery of right ventricle. At least, patients with three of above 5 items should be excluded from primary total correction. 2) Problems and complications at the time of each palliative operation and subsequent total correction a) Some technical difficulties may be encountered in creating subclavian-to-pulmonary artery anasto-mosis for infants with tetralogy of Fallot, because of their smaller size of subclavian artery. At the time of total correction, delayed ligation of the anastomosis is recommended in cases with severe adhesion and expected massive hemorrhage. b) Intrapericardial ascending aorta-to-pulmonary artery anastomosis is the shunt of choice in smaller infants with tetralogy of Fallot. Pulmonary arteries, anastomosed at such an early age, may be deformed so that shunting flow from the aorta passes to unilateral lung, and in such cases reconstruction of deformed pulmonary arteries should be performed at the time of total correction. c) Indications for Brock's operation should be limited to those cases in which there is pulmonary valvular stenosis of localized infundibular stenosis in the right ventricle.
札幌医科大学の論文
1978-04-01

ファロー四徴症の二次的根治手術に関する臨床的研究

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概要

札幌医科大学 | 論文

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