JOURNAL OF CLINICAL SURGERY ›› 2021, Vol. 29 ›› Issue (6): 508-511.doi: 10.3969/j.issn.1005-6483.2021.06.003

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Autogenous pericardium for reconstruction of right ventricular outflow tract and pulmonary artery of PA/VSD in infants

  

  • Online:2021-06-20 Published:2020-06-20

Abstract: Objective:To explore the clinical effect of autologous pericardial tissue reconstruction of right ventricular outflow tractpulmonary artery connection in the treatment of PA/VSD and to summarize experience.Methods:41 cases of PA/VSD from January 2010 to June 2019 were analyzed retrospectively.Thirteen cases received first-stage palliative care and 28 cases received firststage radical treatment. Early postoperative results were analyzed, and the development of right ventricular outflow tract, left and right pulmonary artery, pulmonary artery and tricuspid regurgitation, right ventricular function and other indicators were followed up to evaluate the treatment effect.Results:3 patients died after operation,28 patients underwent primary radical operation,13 patients underwent palliative right ventricular outflow tract reconstruction.The CPB time was(121.2±84.7)min of 38 patients,ventilator assistance time was (184.5±79.3) hours,aortic occlusion time was(85.2±36.4)min,ventilat,ICU stay time was(16.6±7.4)d.Follow up 6 months11 years,1 case died,3 cases had relatively narrow of right ventricular outflow tract or pulmonary artery branch,9 cases had twostage radical operation.Compared with the early postoperative period,the diameter of left and right pulmonary arteries branches increased significantly(P<0.05),and the areas of pulmonary artery regurgitation[(2.46±0.46)cm2 vs(1.18±0.25)cm2 ,P<0.05] and tricuspid valve regurgitation[(1.48±0.26)cm2  vs(0.95±0.21)cm2 ,P<0.05] were larger.Conclusion:Autogenous pericardial reconstruction of right ventricular outflow tract pulmonary artery for PA/VSD shows satisfactory results.During the followup,the right ventricular outflow tract and pulmonary artery branches showed a growing trend,and the degree of pulmonary valve and tricuspid valve regurgitation tended to aggravate.

Key words: pulmonary atresia/ventricular septal defect, autologous pericardium, right ventricular outflow tractpulmonary artery reconstruction, complications

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