婴幼儿法洛四联症根治术后中远期并发症研究进展

Research Progress on Medium- and Long-Term Complications after Radical Correction of Tetralogy of Fallot in Infants and Toddlers

摘要: 法洛四联症(Tetralogy of Fallot, TOF)是最常见的紫绀型先天性心脏病。随着小儿心脏外科技术、围术期管理水平及影像评估手段的不断进步，婴幼儿期行一期根治术已成为主流治疗策略，越来越多的患者能够存活至成年。然而，根治术后心脏中远期并发症仍然是影响患者远期预后和生活质量的重要因素，主要包括肺动脉瓣返流、右心室重构与功能不全、心律失常、心力衰竭及突发性心脏死亡等。近年来，针对TOF根治术后心脏中远期并发症的研究逐渐增多，但具体机制尚未完全阐明，评估方法和干预时机也存在争议。本文围绕婴幼儿期行TOF根治术患者，综述术后中远期并发症的发生机制、影响因素、诊断与治疗进展，以期为优化长期随访和改善患儿远期预后提供参考。

Abstract: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. With continuous advancements in pediatric cardiac surgery techniques, perioperative management, and imaging assessment methods, primary repair during infancy and toddlers has become the mainstream treatment strategy, enabling an increasing number of patients to survive into adulthood. However, medium- and long-term postoperative cardiac complications remain significant factors affecting prognosis and quality of patients’ life, primarily including pulmonary regurgitation, right ventricular remodeling and dysfunction, arrhythmias, heart failure, and sudden cardiac death. In recent years, research on long-term postoperative cardiac complications following TOF repair has gradually increased, but their exact mechanisms have not been fully elucidated, and controversies still exist regarding evaluation methods and intervention timing. This article reviews the mechanisms, influencing factors, diagnostic approaches, and treatment advancements related to medium- and long-term postoperative complications in patients who underwent TOF repair during infancy, aiming to provide insights for optimizing long-term follow-up and improving patient outcomes.