Pulmonary Atresia and Ventricular Septal Defect Repair with Pericardial Tube: A Single Center Retrospective Follow-up Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANXin-jian ,  ZHUANGJian , LIJia-ni , CHENJi-mei , CENJian-zheng , WENShu-sheng , XUGang , ZHANGHong-yu

Department of Cardiovascular Surgery, Southern China Key Laboratory of Structural Heart Disease in Guangdong Province, Guangdong Province Cardiovascular Institution, Guangdong Province General Hospital, Guangzhou 510080, P. R. China;

Corresponding author：

ZHUANGJian, Email: zhuangjian5413@tom.com

Keywords：

Congenital heart disease; Pulmonary atresia; Pericardial tube; Right ventricle outflow tract

DOI：

10.7507/1007-4848.20160226

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Objective To identify the pulmonary artery growth, restenosis and regurgitation of the valve after right ventricle outflow (RVOT) reconstruction with pericardial tube in patients with pulmonary atresia and ventricle septal defect (PA/VSD). Methods We retrospectively analyzed the clinical data of 41 patients with PA/VSD undergoing PA/VSD repair to reconstruct RVOT for radical or palliative repair in our hospital from November 2002 through September 2013. There were 25 males and 16 females with operation age of 4.00 months to 22.70 years (56.60±63.92 months). Late pulmonary artery growth, pulmonary artery, and tricuspid regurgitation of the patients were followed up. Pulmonary atresia and ventricular septal defect repair with pericardial tube were performed in the patients. Results There were 5 (12.19%) early hospital deaths. Thirty-three patients were followed up for 4.00 months to 10.75 years (3.00±2.35 years). Three patients (7.31%) were lost during the follow-up.One patient was dead after stageⅡsurgery. There was no significant growth on the diameters of the tube and the pulmonary artery branches during the follow-up. There were 10 patients with severe stenosis in pericardial tube and 5 patients with moderate or severe stenosis in pulmonary artery branches. The echocardiography suggested the pulmonary artery and tricuspid regurgitation were more serious (P<0.05). No correlation was found between regurgitation quantity and follow-up time. Conclusion The early postoperative results is satisfactory. However, there is no potential growth on the pericardial tube. So the patients should be followed up closely for restenosis.

Citation： YAN Xin-jian, ZHUANG Jian, LI Jia-ni, CHEN Ji-mei, CEN Jian-zheng, WEN Shu-sheng, XU Gang, ZHANG Hong-yu. Pulmonary Atresia and Ventricular Septal Defect Repair with Pericardial Tube: A Single Center Retrospective Follow-up Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(10): 939-943. doi: 10.7507/1007-4848.20160226 Copy

1.	Cho JM, Puga FJ, Danielson GK, et al. Early and long-term results of the surgical treatment of tetralogy of Fallot with pulmonary atresia,with or without major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg, 2002, 124(1): 70-81.
2.	邓喜成, 李守军. 肺动脉闭锁合并室间隔缺损的外科治疗策略. 中国胸心血管外科临床杂志, 2010, 17(1): 50-54.
3.	Tchervenkov CIT, Roy N. Congenital heart surgery nomenclature and database project: pulmonary atresia—ventricular septal defect. Ann Thorac Surg, 2000, 69(4 Suppl): S97-105.
4.	Castaneda AR, Jonas RA, Mayer JEJ, et al. Tetralogy of Fallot. In: Cardiac Surgery of the Neonate and Infant. Castaneda AR, Jonas RA,Hanley FL, Eds.Philadelphia: Saunders, 1994. 215-234.
5.	Amark KM, Karamlou T, O'Carroll A, et al. Independent factors associated with mortality, reintervention, and achievement of complete repair in children with pulmonary atresia with ventricular septal defect. J Am Coll Cardiol, 2006, 47(7): 1448-1456.
6.	Ross DN, Somerville J. Correction of pulmonary atresia with a homograft aortic val ve. Lancet, 1966, 288(7479): 1446-1447.
7.	Sfyridis PG, Avramidis DP, Kirvassilis GV, et al. The Contegra® valved heterograft conduit for right ventricular outflow tract reconstruction: a reliable solution. Hellenic J Cardiol, 2011, 52(6): 501-508.
8.	Bando K, Danielson GK, Schaff HV, et al. Outcome of pulmonary and aortic homografts for right ventricular outflow tract recontraction. J Thorac Cardiovasc Surg, 1995, 109(3): 509-518.
9.	Meyns B, Van Garsse L, Boshoff D et al. The Contegra conduit in the right ventricular outflow tract induces supravalvular stenosis. J Thorac Cardiovasc Surg, 2004, 128(6): 834-840.
10.	徐志伟, 陈道中, 易定华, 等. 肺动脉带瓣管道重建右心室流出道. 中华胸心血管外科杂志, 2012, 28(9): 536-539.
11.	庄建, 张镜芳, 陈欣欣, 等. 肺动脉右心室直接吻合纠治复杂先天性心脏病. 中华胸心血管外科杂志, 2005, 21(3): 130-132.
12.	闫新建, 庄建, 陈寄梅, 等. 肺动脉闭锁合并室间隔缺损行肺动脉下拉重建右心室流出道. 中国胸心血管外科临床杂志, 2014, 21(3): 290-295.
13.	Mair DD, Puga FJ. Management of pulmonary atresia with ventricular septal defect. Curr Treat Options Cardiovasc Med, 2003, 5(5): 409-415.
14.	Sfyridis PG, Avramidis DP, Kirvassilis GV, et al. Right ventricle to pulmonary artery conduit reoperations in patients with tetralogy of fallot or pulmonary atresia associated with ventricular septal defect. Am J Cardiol, 2013, 111(11): 1638-1643.
15.	杨盛春, 陈欣欣, 孙善全, 等. 复杂先天性心脏病右心室流出道重建困难的处理. 中国胸心血管外科临床杂志, 2013, 20(1): 105-107.
16.	Puranik R, Tsang V, Lurz P, et al. Long-term importance of right ventricular outflow tract patch function in patients with pulomanry regurgitation. J Thorac Cardiovasc Surg, 2012, 143(5): 1103-1107.
17.	Derby CD, Kolcz J, Gidding S, et al. Outcomes following non-valved autologous reconstruction of the right ventricular outflow tract in neonates and infants. Eur J Cardiothorac Surg, 2008, 34(4): 726-731.
18.	Schichter AJ, Kreutzer C, Mayorquim RC, et al. Five to fifteen year follow-up of fresh autologous pericardial valved conduits. J Thorac Cardiovasc Surg, 2000, 119(5): 869-879.
19.	Kurotobi S, Taniguchi K, Sano T, et al, Determination of timing for reoperation in patients after right ventricular outflow reconstruction. Am J Cardiol, 2005, 95(11): 1344-1350.
20.	Piazza L, Chessa M, Giamberti A, et al. Timing of pulmonary valve replacement after tetralogy of Fallot repair. Expert Rev Cardiovasc Ther, 2012, 10(7): 917-923.

1. Cho JM, Puga FJ, Danielson GK, et al. Early and long-term results of the surgical treatment of tetralogy of Fallot with pulmonary atresia,with or without major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg, 2002, 124(1): 70-81.
2. 邓喜成, 李守军. 肺动脉闭锁合并室间隔缺损的外科治疗策略. 中国胸心血管外科临床杂志, 2010, 17(1): 50-54.
3. Tchervenkov CIT, Roy N. Congenital heart surgery nomenclature and database project: pulmonary atresia—ventricular septal defect. Ann Thorac Surg, 2000, 69(4 Suppl): S97-105.
4. Castaneda AR, Jonas RA, Mayer JEJ, et al. Tetralogy of Fallot. In: Cardiac Surgery of the Neonate and Infant. Castaneda AR, Jonas RA,Hanley FL, Eds.Philadelphia: Saunders, 1994. 215-234.
5. Amark KM, Karamlou T, O'Carroll A, et al. Independent factors associated with mortality, reintervention, and achievement of complete repair in children with pulmonary atresia with ventricular septal defect. J Am Coll Cardiol, 2006, 47(7): 1448-1456.
6. Ross DN, Somerville J. Correction of pulmonary atresia with a homograft aortic val ve. Lancet, 1966, 288(7479): 1446-1447.
7. Sfyridis PG, Avramidis DP, Kirvassilis GV, et al. The Contegra® valved heterograft conduit for right ventricular outflow tract reconstruction: a reliable solution. Hellenic J Cardiol, 2011, 52(6): 501-508.
8. Bando K, Danielson GK, Schaff HV, et al. Outcome of pulmonary and aortic homografts for right ventricular outflow tract recontraction. J Thorac Cardiovasc Surg, 1995, 109(3): 509-518.
9. Meyns B, Van Garsse L, Boshoff D et al. The Contegra conduit in the right ventricular outflow tract induces supravalvular stenosis. J Thorac Cardiovasc Surg, 2004, 128(6): 834-840.
10. 徐志伟, 陈道中, 易定华, 等. 肺动脉带瓣管道重建右心室流出道. 中华胸心血管外科杂志, 2012, 28(9): 536-539.
11. 庄建, 张镜芳, 陈欣欣, 等. 肺动脉右心室直接吻合纠治复杂先天性心脏病. 中华胸心血管外科杂志, 2005, 21(3): 130-132.
12. 闫新建, 庄建, 陈寄梅, 等. 肺动脉闭锁合并室间隔缺损行肺动脉下拉重建右心室流出道. 中国胸心血管外科临床杂志, 2014, 21(3): 290-295.
13. Mair DD, Puga FJ. Management of pulmonary atresia with ventricular septal defect. Curr Treat Options Cardiovasc Med, 2003, 5(5): 409-415.
14. Sfyridis PG, Avramidis DP, Kirvassilis GV, et al. Right ventricle to pulmonary artery conduit reoperations in patients with tetralogy of fallot or pulmonary atresia associated with ventricular septal defect. Am J Cardiol, 2013, 111(11): 1638-1643.
15. 杨盛春, 陈欣欣, 孙善全, 等. 复杂先天性心脏病右心室流出道重建困难的处理. 中国胸心血管外科临床杂志, 2013, 20(1): 105-107.
16. Puranik R, Tsang V, Lurz P, et al. Long-term importance of right ventricular outflow tract patch function in patients with pulomanry regurgitation. J Thorac Cardiovasc Surg, 2012, 143(5): 1103-1107.
17. Derby CD, Kolcz J, Gidding S, et al. Outcomes following non-valved autologous reconstruction of the right ventricular outflow tract in neonates and infants. Eur J Cardiothorac Surg, 2008, 34(4): 726-731.
18. Schichter AJ, Kreutzer C, Mayorquim RC, et al. Five to fifteen year follow-up of fresh autologous pericardial valved conduits. J Thorac Cardiovasc Surg, 2000, 119(5): 869-879.
19. Kurotobi S, Taniguchi K, Sano T, et al, Determination of timing for reoperation in patients after right ventricular outflow reconstruction. Am J Cardiol, 2005, 95(11): 1344-1350.
20. Piazza L, Chessa M, Giamberti A, et al. Timing of pulmonary valve replacement after tetralogy of Fallot repair. Expert Rev Cardiovasc Ther, 2012, 10(7): 917-923.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Pulmonary Atresia and Ventricular Septal Defect Repair with Pericardial Tube: A Single Center Retrospective Follow-up Study

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