Clinical study of right ventricular outflow tract reconstruction for complex congenital heart disease—a single-center 10-year follow-up analysis
10.7507/1007-4848.201805018
- VernacularTitle:右心室流出道重建术治疗复杂先天性心脏病的临床研究—单中心 10 年随访分析
- Author:
LUO Kai
1
,
2
;
ZHENG Jinghao
1
,
2
;
ZHU Zhongqun
1
,
2
;
PAN Yanjun
1
,
2
;
HE Xiaomin
1
,
2
;
XU Zhiwei
1
,
2
;
LIU Jinfen
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children'
2. s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(2):125-131
- CountryChina
- Language:Chinese
-
Abstract:
Complex congenital heart disease; right ventricular outflow tract reconstruction; autologous tissue; extracardiac conduit:Objective To assess the mid- and long-term outcomes of right ventricular outflow tract reconstruction for children with congenital heart disease. Methods We retrospectively analyzed the clinical data of 3 138 children with complex congenital heart disease in right heart system admitted to our hospital from January 2007 to January 2017. There were 1 660 males and 1 478 females. The age at surgery was 9 days to 84 months, and the body weight was 2.2 to 28.6 kg. Pulmonary patch enlargement was performed in 2 335 patients (1 477 patients of valve-sparing repair and 858 patients of transannular repair); autologous tissue (direct anastomosis, left auricle or pericardial conduit) was used to connect with right ventricle in 289 patients; extracardiac conduits were used for reconstruction in 514 patients. Results There were 181 in-hospital deaths with a mortality of 5.8%. The early postoperative causes of death were low cardiac output syndrome (LCOS), severe pulmonary hypertension and right heart failure. Fifteen patients died of cardiac insufficiency or sudden death during follow-up (6–27 months postoperatively). The echocardiography showed 408 patients with right ventricular outflow tract obsturction (RVOTO), 340 patients with pulmonary trunk or branches stenosis, 609 with pulmonary regurgitation (morderate or severe). 12.6% (394/3 138) of patients underwent reintervention or reoperation with 39 deaths. About 92.4% of patients exhibited an improvement of New York Heart Association (NYHA) functional class from Ⅲ or Ⅳ preoperatively to Ⅰ or Ⅱ at follow-up. Conclusion The anatomical structure of right ventricular outflow tract is complicated and various, and each operation method has different strengths and favorable outcomes. The operation should be individually designed according to pathological types, anatomical features, clinical symptoms and operation conditions.
