Recent advances of pulmonary valve replacement after repairing tetralogy of Fallot

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-01-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.01.018

Feng Chen, Hongmei Li

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Abstract

With constant refining of surgical methods for tetralogy of Fallot (TOF), the survival rate of TOF children has greatly improved. However, the long-term postoperative complications of TOF have become important prognostic factors. The most common complication of pulmonary regurgitation (PR) may lead to right ventricular dysfunction, exercise intolerance, arrhythmia and even sudden death. As an effective treatment for PR, pulmonary valve replacement (PVR) includes surgical pulmonary valve replacement (SPVR), percutaneous pulmonary valve replacement (PPVR) and hybrid therapy. Bioprosthetic valve has remained a primary choice of substituting pulmonary valve. With the improvements of anticoagulation regimens, mechanical valve has its own applicable population and anticoagulation regimens after PVR are also inconsistent. This article reviews the indications of pulmonary valve replacement after radical TOF operations, selecting pulmonary valve replacements, anticoagulant regimens after radical TOF operations and clinical therapeutic advances. Key words: Pulmonary Valve Insufficiency; Tetralogy of Fallot; Pulmonary valve replacement; Research progress

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法洛四联症修复后肺动脉瓣置换术的最新进展

随着法洛四联症(TOF)手术方法的不断完善，TOF患儿的生存率大大提高。然而，TOF术后长期并发症已成为影响预后的重要因素。肺反流(PR)最常见的并发症可导致右心室功能障碍、运动不耐受、心律失常甚至猝死。肺动脉瓣置换术(pulmonary valve replacement, PVR)是肺动脉瓣置换术(PR)的有效治疗方法，包括手术肺动脉瓣置换术(SPVR)、经皮肺动脉瓣置换术(percutaneous pulmonary valve replacement, PPVR)和混合治疗。生物瓣膜一直是替代肺动脉瓣的首选。随着抗凝治疗方案的改进，机械瓣膜有自己的适用人群，PVR后的抗凝治疗方案也不一致。本文综述根治性TOF术后肺动脉瓣置换术的适应证、肺动脉瓣置换术的选择、根治性TOF术后抗凝治疗方案及临床治疗进展。关键词:肺动脉瓣功能不全;法洛四联症;肺动脉瓣置换术;研究进展

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.