Right ventricular-pulmonary artery connection for palliative treatment of pulmonary atresia with ventricular septal defect in children: A single-center retrospective study
- VernacularTitle:右心室-肺动脉连接术姑息性治疗肺动脉闭锁合并室间隔缺损患儿的单中心回顾性研究
- Author:
Shuai ZHANG
1
;
Jianrui MA
1
;
Hailong QIU
1
;
Xinjian YAN
1
;
Wen XIE
1
;
Qiushi REN
1
;
Juemin YU
1
;
Tianyu CHEN
1
;
Yong ZHANG
1
;
Xiaohua LI
1
;
Furong LIU
1
;
Shusheng WEN
1
;
Jian ZHUANG
1
;
Qiang GAO
1
;
Jianzheng CEN
1
Author Information
1. 1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China 2. Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510080, P. R. China
- Publication Type:Journal Article
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(03):366-371
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.
