Evaluation of short-term outcomes of surgical intervention for severe pulmonary stenosis in infants and young children
10.3760/cma.j.cn112434-20250303-00066
- VernacularTitle:婴幼儿期重症肺动脉狭窄外科手术的近期疗效评估
- Author:
Yong ZHANG
1
;
Pengyu WANG
1
;
Liang WANG
1
;
Yiming TAN
1
;
Fangran XIN
1
;
Xu ZHANG
1
;
Chunzhen ZHANG
1
;
Zijun ZHOU
1
;
Lihua LYV
1
;
Minhua FANG
1
Author Information
1. 中国人民解放军北部战区总医院心血管外科，沈阳 100016
- Publication Type:Journal Article
- Keywords:
Severe pulmonary stenosis;
Infant and early childhood surgical intervention;
Short-term therapeutic efficacy;
Right ventricular diastolic function
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(10):584-588
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the short-term efficacy of surgical treatment for severe pulmonary stenosis(PS) in infants and young children, and to clarify the impact of different surgical timings on the efficacy of PS treatment.Methods:A retrospective analysis was conducted on 24 infants and young children who underwent surgical treatment for severe PS at the General Hospital of Northern Theater Command, PLA, from January 1, 2020, to October 1, 2024. Among them, 13 were males and 11 were females. The average weight of the patients was(9.2±3.6) kg, the average gestational age was(39.3±1.7) weeks, and the average age was(15.0±13.5) months. Preoperative clinical symptoms and signs(e.g., cyanosis, shortness of breath), transpulmonary valve pressure gradient(TPVPG), right ventricular systolic pressure(RVSP), and Em/Am were recorded. The patients were divided into two groups based on surgical timing: the infant group(under 1 year old, n=12) and the toddler group(1-3 years old, n=12).Results:There were no deaths among all patients. The postoperative ICU stay was significantly longer in the infant group compared to the toddler group( P<0.05). Compared to preoperative values, surgical treatment significantly improved TPVPG, reduced RVSP, and enhanced right ventricular diastolic function, which stabilized by 3 months postoperatively( P<0.05). Intergroup comparisons revealed that the infant group had significantly lower TPVPG at 6 months postoperatively compared to the toddler group. Additionally, right ventricular diastolic function improved significantly in the infant group postoperatively, while no significant improvement was observed in the toddler group. Younger age and reduced right ventricular diastolic function were identified as major risk factors for prolonged mechanical ventilation(>24 hours). Conclusion:Surgical treatment for PS during infancy and early childhood is safe and effective. Comprehensive preoperative evaluation is crucial, and early surgical intervention is recommended for patients with impaired right ventricular function to improve prognosis.
