Impact of right ventricle to pulmonary artery connection and systemic-to-pulmonary artery shunt surgery on promoting the development of pulmonary vasculature in patients with pulmonary atresia with ventricular septal defect
MA Jian-rui1
ZHANG Shuai1
QIU Hai-long1
ZHENG Hai-yun1
CEN Jian-zheng2
1.Department of Cardiovascular Surgery,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China2.Department of Cardiovascular Surgery,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of Cardiovascular Surgery,Guangdong Cardio-vascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China
摘要：Background Pulmonary atresia with ventricular septal defect(PA/VSD)is a rare and complex congenital heart disease(CHD).The optimal palliative surgical strategy for pulmonary atresia with ventricular septal defect(PA/VSD)in neonates and young infants is controversial.Surgery mainly includes the following two options,right ven-tricle to pulmonary artery connection(RV-PA)and systemic-to-pulmonary artery shunt surgery(SPS).Objectives:To determine the impact of the right ventricle to pulmonary artery connection or systemic-to-pulmonary artery shunt surgery as the initially palliated surgical strategy on promoting the development of pulmonary vasculature in patients with pulmonary atresia and ventricular septal defect(PA/VSD).Methods:From January 2010 to Decem-ber 2019,104 patients with PA/VSD in Guangdong Cardiovascular Institute who underwent right ventricle to pul-monary artery connection or systemic-to-pulmonary artery shunt surgery as the initially palliated surgical strategy to promoting the development of pulmonary vasculature were identified and enrolled in this retrospective study.The cohort was divided into two groups:group-Right Ventricle to Pulmonary Artery Connection(RV-PA),who un-derwent initial palliation with staged repair(n=51),and group-Systemic-to-Pulmonary Artery Shunt(SPS)(n=53).Preoperative and postoperative the development of pulmonary vasculature data have been collected and compared.Results:Before the surgery,the McGoon Ratio of the RV-PA group significantly high than and the SPS group(P＜0.05).After the surgery,in the RV-PA group,the Nakata index,McGoon Ratio score significantly increased during the interstage period(P＜0.01).At the meantime,the HCT,RBC and HB significantly reduced in the RV-PA group compared with the SPS group(P＜0.05).The shunt group performed better in these areas:length of hospital stay,ACC time and CPB time(P＜0.05).Conclusion:Compared with systemic-to-pulmonary artery shunt,right ventri-cle to pulmonary artery connection is more effective to promote the development of the pulmonary vasculature for pulmonary atresia with ventricular septal defect.
机标关键词：connectiondevelopmentsurgeryrightimpactwitharteryatresia
论文发表日期：2022-03-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 33-38 )
英文信息