Tetralogy of Fallot

Tetralogy of Fallot
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法洛四联症

DOI:
10.1017/cbo9780511581656.023
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发表时间:
2009
期刊:
影响因子:
--
通讯作者:
R. Langford
R. Langford
中科院分区:
--
文献类型:
--
作者:
R. Langford

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法洛四联症 (ToF) 发绀新生儿的治疗仍然是一个具有挑战性的情况。过去 30 年来,ToF 的单阶段修复效果稳步改善,3 至 9 个月龄修复效果最佳。紫绀新生儿和小婴儿的传统治疗方法是通过 Blalock-Taussig 分流术进行姑息治疗,但这仍然带来显着的死亡率,即使在当代系列中,死亡率也保持相对稳定。这促进了新生儿完全修复,但对已发表结果的分析表明,与老年修复相比,这也存在显着风险。低出生体重和小肺动脉(PA)仍然是最大的独立危险因素。右心室流出道 (RVOT) 支架置入术可能为高危新生儿提供另一种新生儿修复方法,并允许 PA 生长和延迟修复,直到孩子达到安全年龄。一种分层方法...
Management of the cyanotic neonate with tetralogy of Fallot (ToF) remains a challenging condition. Outcomes for single-stage repair of ToF have steadily improved over the past 30 years and the best results have been achieved with repair between 3 and 9 months of age. The traditional management of cyanotic neonates and small infants has been palliation with a Blalock–Taussig shunt, but this continues to carry a significant mortality that has remained relatively constant even in the contemporary series. This has led to the promotion of neonatal complete repair, but analysis of published outcomes would suggest that this also carries significant risk compared to repair at an older age. Low birth weight and small pulmonary arteries (PAs) remain the greatest independent risk factors. Right ventricular outflow tract (RVOT) stenting may offer an alternative approach to neonatal repair in high-risk neonates and allow for PA growth and delay of repair until the child reaches a safer age. A stratified approach to ea...
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