Repair of pulmonary atresia with ventricular septal defect: choice of right ventricle outflow tract reconstruction
10.3760/cma.j.issn.1001-4497.2016.10.003
- VernacularTitle:肺动脉闭锁合并室间隔缺损矫治术右心室流出道重建方式的选择
- Author:
Xinjian YAN
;
Jian ZHUANG
;
Jiani LI
;
Jimei CHEN
;
Jianzheng CEN
;
Gang XU
;
Shusheng WEN
- Keywords:
Pulmonary atresia;
Ventricular septal defect;
Cardiac surgical procedures;
Right ventricular outflow tract reconstruction
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2016;32(10):590-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the two different ways of right ventricular outflow tract(RVOT) reconstruction at repair of pulmonary atresia with ventricular septal defect,the direct RV-PA anastomosis and pericardial conduit to find the better way.Methods From Jun.2002 to Oct.2012,66 patients underwent pulmonary atresia with ventricular septal defect repair in our hospital,age at operation from 14 days to 272 months.Patients were divided into 2 groups according to the way of RVOT reconstruction.Group 1:31 of them,using direct RV-PA anastomasis,Group 2:35 of them,using pericardial conduit.Paired t test was used to evaluate the growth of pulmonary arteries.Chi-square test and Kaplan-Meier were used to calculate the postoperative mortality,reopemtion situation and survival time.Results There are 3 early hospital death in group 1 (9.7 ％),and 5 in group 2(14.3％),P =0.71.There is a significant difference between the two groups in restenosis rate of the RV-PA anastomasis and autologous pericardial conduit with pulmonary branch artery(Group 1:22.2％,Group 2:55.6％,P =0.01).The diameters of RV-PA anastomasis and the pulmonary artery branches in follow-up were significantly lager than the earlier diameters(P ＜ 0.05) in group 1.There is no growth on diameters of the pericardial conduit and pulmonary branches except the right pulmonary artery in follow-up in group 2.There is no significant difference between the two groups in later survival(P =0.30).Conclusion Both the direct anastomasis of RV-PA and pericardial conduit are available for RVOT reconstruction in pulmonary atresia with ventricular setal defect repair.There is lower incidence of RVOT and pulmonary stenosis and anastomosis absolutely has the ability for later growth in the former.
