Early results of neopulmonary valve creation technique using right atrial appendage tissue
Autor: | Pelin Ayyıldız, Servet Ergün, İsmihan Selen Onan, Ekin Can Çelik, Burak Onan, Erkut Öztürk |
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Rok vydání: | 2020 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Heart Ventricles Operative Time Pulmonary insufficiency 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Cardiopulmonary bypass Humans Ventricular outflow tract Atrial Appendage Child Tetralogy of Fallot Heart Valve Prosthesis Implantation Pulmonary Valve Cardiopulmonary Bypass business.industry Infant Length of Stay Plastic Surgery Procedures medicine.disease Pulmonary Valve Insufficiency Treatment Outcome medicine.anatomical_structure 030228 respiratory system Pulmonary Atresia Ventricle Child Preschool Pulmonary valve Atresia Cardiology Female Surgery Cardiology and Cardiovascular Medicine business Perfusion |
Zdroj: | Journal of Cardiac Surgery. 35:2640-2648 |
ISSN: | 1540-8191 0886-0440 |
Popis: | INTRODUCTION Various valve repair techniques have been described for prevention of pulmonary insufficiency (PI) during right ventricular outflow tract (RVOT) reconstruction with transannular patch. Herein, we present the early results of an alternative technique of neopulmonary valve reconstruction using right atrial appendage (RAA) tissue. METHODS Between October 2019 and December 2019, 12 patients with tetralogy of fallot (TOF) (n = 10), TOF-absent pulmonary valve (n = 1) and intact ventricular septum-pulmonary atresia (n = 1) underwent RVOT reconstruction with neopulmonary valve that was created using RAA tissue. Median age and weight of patients were 9.9 months (5 months-14 years) and 9.8 kg (6.2-47), respectively. RESULTS No mortality or major events developed. Postoperative echocardiography revealed none/trace PI in 11 patients and mild PI in 1 patient. Median right ventricle/left ventricle ratio was 0.46 (0.35-0.65) and RVOT gradient was 20 mm Hg (0-30). Median cardiopulmonary bypass and aortic clamping times were 121 minutes (81-178) and 94 minutes (59-138), respectively. Operative times revealed statistically significant learning curve pattern in terms of cardiopulmonary bypass (r2 = .568; P = .005) and aortic clamping times (r2 = .635; P = .002). Median ventilation time, intensive care unit stay, and the length of hospital stay were 6 hours (2-48), 1 days (1-5), and 7 days (4-10), respectively. Longer perfusion time was not correlated with postoperative times. At median 6 months, echocardiography showed none/trivial PI in 11 patients and mild PI in one patient. CONCLUSION Early results showed that neopulmonary valve reconstruction using the RAA tissue may provide a reasonable alternative for RVOT reconstruction with transannular patch. But long-term results are needed. |
Databáze: | OpenAIRE |
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