Effect of off-pump pulmonary valvotomy as the initial surgery for pulmonary atresia with intact ventricular septum: A single-center clinical analysis
- VernacularTitle:非体外循环下肺动脉瓣切开术初期治疗室间隔完整型肺动脉闭锁的单中心临床分析
- Author:
HE Xiaomin
1
,
2
;
ZHENG Jinghao
1
,
2
;
LUO Kai
1
,
2
;
SUN Qi
1
,
2
;
CHEN Huiwen
1
,
2
;
ZHU Zhongqun
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
- Keywords:
Pulmonary atresia with intact ventricular septum;
initial surgery;
pulmonary valvulotomy;
hybrid therapy;
off-pump
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(04):411-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of off-pump pulmonary valvulotomy for the patients with pulmonary atresia with intact ventricular septum (PA/IVS). Methods The clinical data of 61 PA/IVS patients who underwent off-pump right ventricular decompression surgery in our hospital from January 2013 to September 2019 were retrospectively analyzed, including 37 males and 24 females, with an average age of 29.7 (2.0-86.0) d and weight of 4.1 (2.5-6.9) kg. Thirty-nine patients received off-pump pulmonary valvulotomy (an open-view valvulotomy group) and 22 patients received balloon valvuloplasty through the right ventricle pulmonary valve (a hybrid therapy group). The postoperative mortality, early re-intervention, and completion of final operation of the two groups were compared. Results There were 2 deaths in the study with a mortality rate of 3.3% (2/61), and the mortality rate of the two groups was not significantly different (2.6% vs.4.5%, P=0.68). The rate of early re-intervention in the two groups was 5.3% and 19.0%, respectively (P=0.09). There was no statistical difference in intubation time (56.0±25.9 h vs. 62.0±28.9 h, P=0.41), ICU retention time (4.7±2.9 d vs. 5.5±2.2 d, P=0.23) and postoperative hospital stay time (3.9±0.9 d vs. 4.3±1.1 d, P=0.38) between the two groups. The follow-up time was 45.3 (4.0-84.0) months. There were 5 patients lost to follow-up. During the follow-up period, in the open-view valvulotomy group, 17 patients did not need further operation, 13 patients completed the final operation. In the hybrid therapy group, 7 patients did not need further operation, 8 patients completed the final operation. Heart function classification of all patients was in New York Heart Association class Ⅰ-Ⅱ. Conclusion Compared with the hybrid therapy, off-pump pulmonary valvulotomy for PA/IVS also has the advantages of simple operation, short operation time and high survival rate, and it may be easier to be promoted in clinical application because of its more economic benefits and relatively lower re-intervention rate.
