Mustafa Kemal Avşar, Ramush Bejiqi, Yasin Güzel, Cenap Zeybek, Barıs Kirat, İbrahim Ozgur Onsel, Mehmet Salih Bilal
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引用次数: 0
摘要
目的：探讨法洛四联修复术后慢性肺反流对右心室的影响。本研究评估了采用右心房组织进行肺动脉瓣重建与标准经环补片修复的早期结果。方法：对2014-2024年412例法洛四联症患者进行回顾性分析：心房瓣膜组（205例）行瓣膜重建；无阀组（n = 207）接受标准修复。患者随访1年，进行超声心动图评估。结果包括右心室功能不全、通气时间和ICU住院时间。结果：心房瓣膜组在12个月时出现右下心室功能不全（9.3% vs. 19.8%, p = 0.004, OR = 2.39, 95% CI: 1.32-4.33），通气时间缩短（6.1 vs. 18.0小时，p < 0.001, Cohen’s d = 3.54）， ICU住院时间缩短（3.0 vs. 5.7天，p < 0.001, Cohen’s d = 1.87）， CPB持续时间延长（47.1 vs. 40.5分钟，p = 0.02）。结论：右心房组织重建可减少法洛四联症修复后早期和中期右室功能障碍。需要长期研究。
Early results of complete surgical correction of tetralogy of Fallot with pulmonary valve formation from the right atrium: a comparative analysis with traditional correction without valve construction.
Objective: Chronic pulmonary regurgitation following tetralogy of Fallot repair burdens the right ventricle. This study evaluated early outcomes of pulmonary valve reconstruction using right atrial tissue versus standard transannular patch repair.
Methods: A retrospective analysis of 412 tetralogy of Fallot patients (2014-2024) was conducted: Atrial Valve Group (n = 205) underwent valve reconstruction; No-Valve Group (n = 207) received standard repair. Patients were followed for 1 year with echocardiographic assessments. Outcomes included right ventricular insufficiency, ventilation duration, and ICU stay.
Results: Atrial Valve Group had lower right ventricular insufficiency at 12 months (9.3% vs. 19.8%, p = 0.004, OR = 2.39, 95% CI: 1.32-4.33), shorter ventilation times (6.1 vs. 18.0 hours, p < 0.001, Cohen's d = 3.54), and reduced ICU stays (3.0 vs. 5.7 days, p < 0.001, Cohen's d = 1.87), despite longer CPB durations (47.1 vs. 40.5 minutes, p = 0.02).
Conclusions: Right atrial tissue reconstruction reduces early and intermediate-term right ventricular dysfunction post-tetralogy of Fallot repair. Long-term studies are needed.
期刊介绍：
Cardiology in the Young is devoted to cardiovascular issues affecting the young, and the older patient suffering the sequels of congenital heart disease, or other cardiac diseases acquired in childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in the its mission, helping to make it the essential journal in paediatric cardiology. All aspects of paediatric cardiology are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development.
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