Impact of Right Ventricle to Pulmonary Artery Connection or Systemic-to-Pulmonary Artery Shunt Surgery on Promoting the Development of Pulmonary Vasculature in Patients With Pulmonary Atresia and Ventricular Septal Defect
10.3969/j.issn.1000-3614.2018.11.015
- VernacularTitle:不同姑息性手术对肺动脉闭锁合并室间隔缺损患者肺血管发育促进作用的比较
- Author:
Yong-Hui ZHANG
1
;
Zhong-Dong HUA
;
Xu WANG
;
Jun YAN
;
Qiang WANG
;
Shou-Jun LI
;
Kai MA
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 小儿心脏外科中心
- Keywords:
Pulmonary atresia with ventricular septal defect;
Hypoplastic pulmonary arteries;
The right ventricle to pulmonary artery connection;
Systemic-to-pulmonary artery shunt
- From:
Chinese Circulation Journal
2018;33(11):1108-1112
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To compare the effect between the right ventricle to pulmonary artery connection and the systemic-to-pulmonary artery shunt palliative surgery in patients with pulmonary atresia and ventricular septal defect. Methods: A total of 92 consecutive patients (mean age [1.69 ± 1.72] years, range 0.2-8.1 years) diagnosed with pulmonary atresia, ventricular septal defect and pulmonary artery hypoplasia (Nakata index [87.51 ± 36.97] mm2/m2; McGoon ratio 0.97±0.28) from December 2009 to August 2012 in our hospital were included in this retrospective study. 45 patients underwent the procedure of right ventricle to pulmonary artery connection (RV-PA) and 47 underwent the systemic-to-pulmonary artery shunt surgery, some patients also received simultaneous transcatheter occlusion of major aortopulmonary collaterals and/or pulmonary angioplasty. The mechanical ventilation time and ICU monitoring time, the pulmonary vascular growth and the anatomical repair rate were compared between the two groups. Results: The mean follow up time was (2.01±1.02)years. Nakata index and McGoon ratio equally increased significantly post operation as compared to baseline level (P<0.001). Incidence of final anatomical repair was significantly higher in the RV-PA group than in the systemic-to-pulmonary artery shunt group (62.2% vs 31.9%,P<0.01). During the anatomical repair operation, the incidence of cyanosis improvement was significantly higher, while the operation time was significantly shorter in the RV-PA group than in the systemic-to-pulmonary artery shunt group(both P<0.05). Mechanical ventilation time and ICU monitoring time also tended to be shorter in the RV-PA group (P>0.05). Conclusions: The palliative right ventricle to pulmonary artery connection surgery is related to higher rate of final anatomical repair in patients with pulmonary atresia and ventricular septal defect and may help the patients recover after the anatomical repair.
