Polytetrafluoroethylene graft calcification in patients with surgically repaired congenital heart disease: Evaluation using multidetector-row computed tomography
Polytetrafluoroethylene graft calcification in patients with surgically repaired congenital heart disease: Evaluation using multidetector-row computed tomography
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DOI：
10.1016/j.ahj.2007.01.035
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发表时间：
2007-05-01
影响因子：
4.8
通讯作者：
Kagami, Shoji
中科院分区：
文献类型：
--
作者：
Hayabuchi, Yasunobu;Mori, Kazuhiro;Kagami, Shoji
背景 钙化假体聚四氟乙烯 (PTFE) 的无创测定对于改善风险分层非常重要。本研究的目的是评估多排计算机断层扫描 (MDCT) 用于评估手术修复先天性心脏病患者 PTFE 钙化的可行性，并评估特定手术过程中钙化的发展和特征。 方法 通过 MDCT 评估 47 名患者的 76 个植入的 PTFE 移植物（Aquillion 16，东芝公司，日本东京）。对 4 例 MDCT 扫描后接受再次手术的患者进行组织学评估。 结果 29 例室间隔缺损 (VSD) 补片中，5 例 (17%) 检测到 PTFE 钙化；32 例右心室流出道 (RVOT) 补片中，26 例 (81%) 检测到 PTFE 钙化；Fontan 手术的房间隔补片 8 例中，2 例 (25%) 检测到 PTFE 钙化；对于总腔肺连接的心外导管，为 7 (100%)。 PTFE 的 CT 衰减显示 VSD 补片（114 +/- 61 Hounsfield 单位 [HU]）、RVOT 假体（243 +/- 132 HU）、房间隔补片（163 +/- 161 HU）和心外导管（230 +/- 29 HU）的值显着不同（P < .0001）。 VSD 补片的 CT 密度值显着低于 RVOT 移植物和心外导管 (P < .05)。 MDCT 结果与钙化评估中的组织学分析一致。结论本研究表明 MDCT 能够评估假体 PTFE 移植物的钙化； 4 个不同植入部位的 PTFE 移植物表现出独特的特征和钙化的普遍性。
Background Noninvasive determination of calcified prosthetic polytetrafluoroethylene (PTFE) is important in improving risk stratification. The purpose of this study is to assess the feasibility of multidetector-row computed tomography (MDCT) for the evaluation of PTFE calcification in patients with surgically repaired congenital heart disease and to evaluate the development and characteristics of calcification for specific surgical procedures.Methods Seventy-six implanted PTFE grafts in 47 patients were evaluated by MDCT (Aquillion 16, Toshiba Corporation, Tokyo, Japan). Explanted PTFE grafts were evaluated histologically in 4 patients who underwent reoperation after MDCT scans.Results Calcification of prosthetic PTFE was detected in 5 of 29 cases (17%) for ventricular septal defect (VSD) patches, 26 of 32 (81%) for right ventricular outflow tract (RVOT) prosthesis, 2 of 8 (25%) for atrial septal patches of the Fontan procedure, and 7 of 7 (100%) for extracardiac conduits of total cavopulmonary connection. The CT attenuation of PTFE revealed significantly different values for VSD patches (114 +/- 61 Hounsfield units [HU]), RVOT prosthesis (243 +/- 132 HU), atrial septal patches (163 +/- 161 HU), and extracardiac conduits (230 +/- 29 HU) (P < .0001). The CT density value of VSD patches was significantly lower than those of RVOT grafts and extrocardiac conduits (P < .05). The MDCT findings were consistent with histologic analysis in the evaluation of calcification.Conclusions This study demonstrates that MDCT enables the evaluation of prosthetic PTFE graft calcification; PTFE grafts in 4 different implantation sites demonstrated distinctive features and the prevalence of calcification.