Factors associated with marked reduction in mortality for Fontan operations in patients with single ventricle.
Factors associated with marked reduction in mortality for Fontan operations in patients with single ventricle.
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单心室患者 Fontan 手术死亡率显着降低的相关因素。
DOI：
10.1016/s0022-5223(19)34983-9
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Aldo R. Castaneda
中科院分区：
文献类型：
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作者：
J. Mayer;Nancy D. Bridges;James E. Lock;F. Hanley;R. Jonas;Aldo R. Castaneda
Fontan手术最初用于三尖瓣闭锁患者，但其应用已扩展到具有各种复杂缺陷的患者，这些患者在功能上只有一个心室室。本文回顾了1984~1990年间在波士顿儿童医院为三尖瓣闭锁以外的其他畸形患者施行的225例改良Fontan手术的结果。共有30例患者(13.3%)手术失败(死亡或被取下)。在研究期间，结果显著改善，在最后两年的回顾中，失败率分别为6.5%(2/31)和3.4%(2/59)。多因素分析显示，肺动脉变形、肺动脉压、年龄小于3岁、使用无氧葡萄糖K+停搏液、体外循环时间大于180分钟与预后较差有关，而房室瓣解剖“良好”(非左房室瓣狭窄/闭锁或共同房室瓣)和年龄大于9岁与预后改善相关。从多因素分析中剔除体外循环时间，左房室瓣闭锁/狭窄患者的房室间隔技术成为最重要的变量，其次是初始多因素分析中除年龄>9岁外的其他变量。在研究的最后两年中，31.1%的患者年龄在3岁以下。在研究期间，术前危险因素没有明显下降。这些结果表明，改良Fontan手术在经过适当选择的复杂缺陷患者中成功的可能性很高，这些患者的功能只有一个脑室。(胸心外科杂志1992；103：444-52)
The Fontan operation was originally employed for patients with tricuspid atresia, but its application has been extended to those with a variety of complex defects in which there is functionally only a single ventricular chamber. The outcome of 225 modified Fontan operations carried out between 1984 and 1990 at the Children's Hospital, Boston, for patients with defects other than tricuspid atresia was reviewed. Overall 30 patients (13.3 %) had failure of this operation (death or takedown). Results improved significantly during the period of the study, with failure rates of 6.5% (2 of 31) and 3.4% (2 of 59) in the last 2 years of the review. Multivariate analysis showed that pulmonary artery distortion, pulmonary artery pressure, age less than 3 years, use of a nonoxygenated glucose K+cardioplegic solution, and cardiopulmonary bypass time greater than 180 minutes were associated with worse outcome, while “favorable” atrioventricular valve anatomy (non-left atrioventricular valve stenosis/ atresia or common atrioventricular valve) and age greater than 9 years were associated with improved outcome. Excluding cardiopulmonary bypass time from the multivariate analysis, the technique of atrial partitioning for patients with left atrioventricular valve atresia/stenosis became the most important variable, followed by the others noted in the initial multivariate analysis except for age greater than 9 years. In the last 2 years of the study 31.1 % of patients were less than 3 years of age. During the period of the study there was no significant decline in preoperative risk factors. These results show that modified Fontan operations can be carried out with a high likelihood of success in properly selected patients with complex defects in whom there is functionally a single ventricle. (J ThoracCardiovascSurg1992;103:444-52)
逮捕期间心肌内 pH 值的在线监测反映了用含氧心脏停跳液改善了心肌保存。
DOI：
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发表时间：
1986
期刊：
Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
影响因子：
--
作者：
Randolph,JD;Toal,KW;Geffin,GA;DeBoer,LW;O'Keefe,DD;Khuri,SF;Daggett,WM
通讯作者：
Daggett,WM
增强缺血性骤停期间的心肌保护。
DOI：
--
发表时间：
1983
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Bodenhamer,RM;DeBoer,LW;Geffin,GA;O'Keefe,DD;Fallon,JT;Aretz,TH;Haas,GS;Daggett,WM
通讯作者：
Daggett,WM
普鲁卡因和洗涤的红细胞在 5°C 下灌注的离体狗心脏中的作用。
DOI：
--
发表时间：
1982
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Suaudeau,J;Shaffer,B;Daggett,WM;Austen,WG;Erdmann3rd,AJ
通讯作者：
Erdmann3rd,AJ