Establishment of right ventricle-pulmonary artery continuity as the first-stage palliation in older infants with pulmonary atresia with ventricular septal defect may be preferable to use of an arterial shunt
OBJECTIVES: Right ventricle-pulmonary artery (RV-PA) conduit and systemic-to-pulmonary artery (S-PA) shunt in younger infants for the first-stage palliation with pulmonary atresia with ventricular septal defect (PAVSD) obtained good results. However, the pulmonary arteries (PA) grow slow in older infants undergoing an S-PA shunt. We compared the clinical outcomes of the two procedures in older infants with PAVSD. METHODS: A total of 48 patients with PAVSD underwent the first-stage palliative procedure between January 2010 and July 2012. Patients were divided into the RV-PA group and the S-PA group based on whether they had an RV-PA conduit (n = 24) or an S-PA shunt (n = 24). The early and late outcomes were compared between groups. RESULTS: There was no significant difference in in-hospital mortality, mechanical ventilation time, paediatric intensive care unit stay and hospital stay between groups (all P > 0.05). The RV-PA conduits were associated with better PA growth compared with the S-PA shunts (P < 0.001). The RV-PA group had a higher rate of second-stage biventricular surgery compared with the S-PA group (P = 0.03). The early outcomes among different conduits of the RV-PA conduit were not different (all P > 0.05). A positive correlation was found between the size of conduits and body weight (R-2 = 0.684, P < 0.001). CONCLUSIONS: In older infants with PAVSD who underwent the first-stage palliative procedure, early outcomes showed no difference between the RV-PA conduit group and the S-PA shunt group. The RV-PA conduits were associated with better growth of the PA and higher rates of second-stage biventricular repair. Autologous pericardium is a good choice for RV-PA conduits, and there is a correlation between body weight and size of conduit.
基金：
Program for Peking Union Medical College Scholars and Innovative Research Team [2011-XH7]
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2013]版：
大类|4 区医学
小类|4 区心脏和心血管系统
最新[2023]版：
大类|4 区医学
小类|4 区心脏和心血管系统4 区呼吸系统4 区外科
JCR分区：
出版当年[2012]版：
Q4CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版：
Q2SURGERYQ3CARDIAC & CARDIOVASCULAR SYSTEMSQ3RESPIRATORY SYSTEM
第一作者机构：[1]Natl Ctr Cardiovasc Dis, Dept Surg, Beijing 100037, Peoples R China;[2]Chinese Acad Med Sci, Fuwai Hosp, Beijing 100037, Peoples R China;[3]Peking Union Med Coll, Beijing 100037, Peoples R China;[4]Capital Med Univ, Anzhen Hosp, Dept Cardiac Surg, Beijing, Peoples R China;
通讯作者：
通讯机构：[1]Natl Ctr Cardiovasc Dis, Dept Surg, Beijing 100037, Peoples R China;[2]Chinese Acad Med Sci, Fuwai Hosp, Beijing 100037, Peoples R China;[3]Peking Union Med Coll, Beijing 100037, Peoples R China;[5]Natl Ctr Cardiovasc Dis, Dept Surg, 167A Beilishi Rd, Beijing 100037, Peoples R China
推荐引用方式(GB/T 7714)：
Zheng Shuai,Yang Keming,Li Kun,et al.Establishment of right ventricle-pulmonary artery continuity as the first-stage palliation in older infants with pulmonary atresia with ventricular septal defect may be preferable to use of an arterial shunt[J].INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY.2014,19(1):88-94.doi:10.1093/icvts/ivu052.
APA：
Zheng, Shuai,Yang, Keming,Li, Kun&Li, Shoujun.(2014).Establishment of right ventricle-pulmonary artery continuity as the first-stage palliation in older infants with pulmonary atresia with ventricular septal defect may be preferable to use of an arterial shunt.INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY,19,(1)
MLA：
Zheng, Shuai,et al."Establishment of right ventricle-pulmonary artery continuity as the first-stage palliation in older infants with pulmonary atresia with ventricular septal defect may be preferable to use of an arterial shunt".INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY 19..1(2014):88-94
