複雜性先天心臟病術前術後心律不整之電生理學機轉：以同步電位及之體結構定位法研究(2/3)
Date Issued
2001
Date
2001
Author(s)
吳美環
DOI
892314B002492
Abstract
Sudden death in patients with right atrial
isomerism after palliation
Objectives. This longitudinal study sought
to define the risk of sudden death in patients
with right atrial isomerism (RAI, asplenia)
after palliation.
Study design. A total of 154 patients with
RAI were identified from 1980 to 1999 based
on a combination of various imaging
techniques. Open-heart surgery or autopsy in
52 cases confirmed the diagnosis. Sudden
death was defined as acute cardiovascular
collapse from which biological death
occurred within 24 hours.
Results. A total of 620 patient-years were
derived. The one-year and five-year survival
was 72% and 50%, respectively. There were
a total of 22 sudden unexpected deaths (14%,
35 events/1,000 patient-years). Sudden
death tended to occur in the infancy or early
childhood (12±9 mo., median, 9 mo.). The
mechanisms were classified as sudden
tachyarrhythmic in 2 (9%), sudden cardiac
but nontachyarrrhythmic(sudden onset severe
cyanosis) in 15 (68%), and sudden
noncardiac in 5 (23%)(fulminant sepsis with
positive blood culture: streptococcus
pneumonia 3, E. coli 1 and yeast-like
organism 1). Freedom from sudden death
steadily decreased with age until the age of 3
years.
Conclusions. The incidence of sudden
death in RAI patients after initial palliation
was still very high. The sudden death was
related to the complex cardiac anomalies per
se, a susceptibility to fulminant infection, and
arrhythmia.
Subjects
Sudden death
complex congenta heart disease
conduction system anomalies
Publisher
臺北市：國立臺灣大學醫學院小兒科
Type
report
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