Valved homograft conduit repair of the right heart in early infancy.
Valved homograft conduit repair of the right heart in early infancy.
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DOI：
10.1016/s0003-4975(99)00614-1
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发表时间：
1999-08
期刊：
影响因子：
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通讯作者：
J. Perron;A. Moran;K. Gauvreau;P. Nido;J. Mayer;R. Jonas
中科院分区：
文献类型：
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作者：
J. Perron;A. Moran;K. Gauvreau;P. Nido;J. Mayer;R. Jonas
背景新生儿和小婴儿带瓣同种移植导管修复术可建立生理上正常的双心室循环，并且与分流术不同，可以避免对肺分支进行手术。方法对 1990 年至 1995 年间接受手术的 84 名患者（平均年龄 26 ± 28 天，平均体重 3.3 ± 0.8 kg）进行回顾性图表审查，这些患者在生命的前 3 个月内接受同种移植导管修复。病例分为简单病例和复杂病例，例如肺动脉瓣缺失综合征或相关弓断。平均同种移植物大小为 9.0 ± 2 mm。结果早期死亡率为 4.7%（简单）和 30%（复杂）。平均住院时间为 18 天。平均随访时间为 34 个月。三十七名 (47%) 患者接受了导管更换。再手术的中位时间为 3.1 年。替代同种移植物的平均尺寸为 17 ± 2 mm。再次手术时没有死亡。更换导管后的平均住院时间为 6.3 天。 5 年生存概率为 75%。 结论 对于出生后 3 个月内的非复杂异常，采用导管进行双心室修复可以安全地进行。重复手术的时间间隔相对较短，但等于或大于大多数姑息手术的时间间隔。
BackgroundValved homograft conduit repair in neonates and young infants creates a physiologically normal biventricular circulation, and unlike shunts, avoids surgery on the branch pulmonary.MethodsRetrospective chart review was used for 84 patients operated on between 1990 and 1995 (mean age 26 ± 28 days, mean weight 3.3 ± 0.8 kg) undergoing homograft conduit repair in the first 3 months of life. Cases were divided into simple and complex, eg, absent pulmonary valve syndrome or associated interrupted arch. Mean homograft size was 9.0 ± 2 mm.ResultsEarly mortality was 4.7% (simple) and 30% (complex). Mean hospital stay was 18 days. Mean follow-up was 34 months. Thirty-seven (47%) patients underwent conduit replacement. Median time to reoperation was 3.1 years. Mean size of replacement homograft was 17 ± 2 mm. There were no deaths at reoperation. Mean hospital stay at conduit change was 6.3 days. Probability of survival at 5 years is 75%.ConclusionsBiventricular repair employing a conduit can be performed safely in noncomplex anomalies in the first 3 months of life. Time interval until repeat surgery is relatively short but equal or greater than that with most palliative procedures.