Midterm Outcomes for Polytetrafluoroethylene Valved Conduits
Midterm Outcomes for Polytetrafluoroethylene Valved Conduits
复制标题
聚四氟乙烯阀门导管的中期成果
DOI：
10.1016/j.athoracsur.2021.09.051
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发表时间：
2022-10-21
影响因子：
4.6
通讯作者：
Zhang, Huifeng
中科院分区：
文献类型：
--
作者：
Shi, Qiqi;Shan, Yaping;Zhang, Huifeng
背景技术各种用于右心室流出道重建的导管已有报道，但大多数在国内尚无。研究人员使用膨体聚四氟乙烯 (ePTFE) 开发了一种简单的手工缝制阀门导管。本研究评估了该管道的中期结果。方法 本回顾性研究共纳入 72 例 2014 年 1 月至 2020 年 6 月期间接受 ePTFE 带瓣导管右心室流出道重建的患者。随访期间，对所有患者进行超声心动图检查，对法洛四联症修复术后患者进行磁共振成像检查。结果 患者的中位年龄为 69 个月（四分位距，28-127 个月），中位随访时间为 33 个月（四分位距，9-51 个月）。无早期死亡，但发生晚期死亡2例（2.78%）。中位导管尺寸为 18 mm（四分位距，18-20 mm），z 分数为 +1.3（四分位距，+0.6-+2）。 ePTFE 阀门的峰值速度为 2.38 m/s（95% CI，2.11-2.63 m/s）。 27 名患者 (38.5%) 没有肺动脉瓣反流或很轻微，42 名患者 (60.0%) 患者有轻微肺动脉瓣反流，1 名患者 (1.4%) 存在中度肺动脉瓣反流。 5例患者出现导管功能障碍：4例导管中度狭窄，1例中度反流。法洛四联症修复术后右心室舒张末期容积指数显着下降（171 mL/m2 vs 130 mL/m2；P < .001）。无需重新干预或更换导管。结论 这种手工缝制的 ePTFE 带阀导管与中期随访期间明显的血流动力学结果相关。需要长期随访研究来证实这些发现。 (Ann Thorac Surg 2022;114:1778-85) (c) 2022 年，胸外科医师协会
BACKGROUND Various conduits for right ventricular outflow tract reconstruction have been reported, but most of them are not available in China. The study investigators developed a simple handsewn valved conduit using expanded polytetrafluoroethylene (ePTFE). This study evaluated the midterm outcomes for this conduit. METHODS This retrospective study included a total of 72 patients who underwent right ventricular outflow tract reconstruction with ePTFE valved conduits between January 2014 and June 2020. During follow-up, echocardiograms were performed for all patients, and magnetic resonance imaging was performed for patients with repaired tetralogy of Fallot. RESULTS Patients had a median age of 69 months (interquartile range, 28-127 months) and a median follow-up period of 33 months (interquartile range, 9-51 months). There was no early death, but 2 late deaths (2.78%) occurred. The median conduit size was 18 mm (interquartile range, 18-20 mm) and the z score was +1.3 (interquartile range, +0.6-+2). Peak velocity across the ePTFE valve was 2.38 m/s (95% CI, 2.11-2.63 m/s). Pulmonary valve regurgitation was none or trivial in 27 (38.5%) patients, mild in 42 (60.0%) patients, and moderate in 1 (1.4%) patient. Conduit dysfunction occurred in 5 patients: 4 had moderate conduit stenosis, and 1 had moderate regurgitation. The right ventricular end-diastolic volume index in repaired tetralogy of Fallot was significantly decreased after surgery (171 mL/m2 vs 130 mL/m2; P < .001). No reintervention or conduit replacement was needed. CONCLUSIONS This handsewn ePTFE valved conduit was associated with appreciable hemodynamic outcomes during the midterm follow-up period. Long-term follow-up studies are needed to corroborate these findings. (Ann Thorac Surg 2022;114:1778-85) (c) 2022 by The Society of Thoracic Surgeons