Long-term results of total repair of tetralogy of Fallot in adulthood: 35 years follow-up in 104 patients corrected at the age of 18 or older
Long-term results of total repair of tetralogy of Fallot in adulthood: 35 years follow-up in 104 patients corrected at the age of 18 or older
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DOI：
10.1055/s-2007-1013719
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发表时间：
1997-08-01
影响因子：
1.5
通讯作者：
Klinner, W
中科院分区：
文献类型：
--
作者：
Nollert, G;Fischlein, T;Klinner, W
据报道，法洛四联症（TOF）手术修复后的长期生存率是极好的，如果患者在儿童时期得到纠正。然而，手术年龄已被证明是一个重要的风险因素。我们研究的目的是调查成人患者是否也从手术中受益。从1958年12月至1977年5月，739例患者在我们的机构接受了肺动脉狭窄TOF矫正术。外国人（n=52）和移居外国的人（n=13）被排除在进一步分析之外。16例患者在随访期间失访（98%完成）。在其余患者人群中（n=658;平均年龄：12.2 ± 8.6岁;范围2-67岁），104例患者在矫正时≥ 18岁。长期计算排除了手术（n=25）和1年（n=8）死亡，研究组有71例患者。10、20、30和35年生存率分别为94%、93%、83%和72%，与正常预期寿命无差异。最常见的死亡原因是充血性心力衰竭（n=3），其次是心肌梗死（n=2）和猝死（n=2）。无法检测到影响长期生存的参数。在随访时（平均27.7年），58名幸存者中超过80%（n=48）报告自己处于NYHA心功能I级或II级，95%（n=55）的状况比术前更好。成年期法洛四联症根治术效果良好，患者预期寿命正常。
Long-term survival after surgical repair of tetralogy of Fallot (TOF) is reported to be excellent if the patients are corrected in childhood. However, age at operation has been demonstrated as an important risk-factor. The aim of our study was to investigate whether adult patients also benefit from surgery. From December 1958 to May 1977, 739 patients underwent a correction of their TOF with pulmonary stenosis at our institution. Foreigners (n=52) and those who moved to a foreign country (n=13) were excluded from further analysis. Sixteen patients were lost during follow-up (98% complete). Of the remaining patient population (n=658; mean age: 12.2 +/- 8.6 years; range 2-67 years), 104 patients were 18 years or older at-the time of correction. Operative (n=25) and one-year (n=8) deaths were excluded for long-term calculations, resulting in a study group of 71 patients. Actuarial 10,20,30, and 35-year survival rates were 94%,93%,83%, and 72% respectively, and not different from normal life expectancy. The most common cause of death was congestive heart failure (n=3), followed by myocardial infarction (n=2) and sudden death (n=2). Parameters influencing longterm survival could not be detected. At follow-up (mean 27.7 years), more than 80% (n=48) of the 58 survivors reported themselves to be in NYHA functional class I or II and 95% (n=55) were in a better condition than before the operation. Repair of tetralogy of Fallot in adulthood shows excellent results with normal life expectancy for the patients.