Long-term course after pediatric right ventricular outflow tract reconstruction
| Autor: | Chalit Cheanvechai, Mueanthep Chomvilailuk, Pimchanok Junnil, Vichai Benjacholamas, Puwadon Thitivaraporn, Jule Namchaisiri, Ankavipar Saprungruang |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Heart Defects Congenital Reoperation medicine.medical_specialty Heart Ventricles Ventricular Outflow Obstruction 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Ventricular outflow tract Humans Child Survival rate Retrospective Studies Bioprosthesis business.industry Infant General Medicine Truncus Arteriosus Persistent surgical procedures operative medicine.anatomical_structure Treatment Outcome 030228 respiratory system Early results Pulmonary valve cardiovascular system Cardiology Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Asian cardiovascularthoracic annals. 29(6) |
| ISSN: | 1816-5370 |
| Popis: | Objectives Valved homografts are commonly used for right ventricular outflow tract reconstruction. However, despite good early results, they lack durability. This study was designed to compare single-center results of implantation of 3 types of right ventricular outflow tract conduit, in terms of patient survival, graft failure, reoperation, and risk factors for reoperation. Methods One hundred and forty-three pediatric patients who underwent right ventricular outflow tract conduit implantation between January 2006 and December 2018 were reviewed. We stratified conduits by aortic, pulmonic homograft, and Contegra; 74 aortic homografts, 61 pulmonic homografts, and 8 Contegra conduits were implanted. Median age at implantation was 3 years. The primary diagnosis was truncus arteriosus in 41.3%. We analyzed the role of sex, age, diagnosis, and graft size. Endpoints included freedom from graft failure, freedom from reoperation, and survival. Results The survival rate was 83.2% at 10 years. Freedom from graft failure at 2, 5, and 10 years was 100%, 97.9%, and 63.4%, respectively. Freedom from reoperation was 85.8% for pulmonic homografts and 74.9% for aortic homografts at 10 years, and 100% for Contegra at 6 years. Multivariable analysis identified conduit diameter Conclusion Homograft valves used for right ventricular outflow tract reconstruction provided excellent long-term durability and late survival. The only factor that adversely affected graft longevity was small graft size (diameter |
| Databáze: | OpenAIRE |
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