Abstract：
BACKGROUND: Repair of congenital heart defects involving the right ventricular outflow tract may require the implantation of a right ventricle to pulmonary artery conduit. This conduit is likely to be replaced during childhood. This study compares the operative outcomes of the replacement procedure of Contegra® and homografts in pulmonary position.
METHODS: From 1999 to 2016, 82 children underwent 87 right ventricle to pulmonary artery conduit replacements (60 Contegra® and 27 homografts). Demographics, operative and clinical data were obtained through a retrospective review of the medical records. The two groups were matched for comparison using propensity score matching. All the procedures were performed by the same team of surgeons.
RESULTS: No statistically significant difference was observed between the two groups when considering the operative data for anesthesia, surgery, cardiopulmonary bypass and aortic clamping durations. A peroperative complication rate of 13.47% and 15.36% in Contegra® and homograft replacement groups respectively (p value = 0.758) was observed. There was no difference regarding the blood loss and fluid input. No statistically significant difference was observed between the two groups for the post-operative morbidity. We considered the Pediatric Risk of Mortality (PRISM) score, the day of extubation, the day of withdrawal of inotropic drugs, the length of the intensive care unit stay and the length of hospital stay. The overall mortality is 2.3% but there is no statistically significant difference between the two groups.
CONCLUSIONS: Right ventricle to pulmonary artery conduit replacement procedure can be achieved with a low surgical morbidity or mortality, not influenced by the type of conduit that is replaced. Therefore, the choice between homograft or Contegra® for right ventricle to pulmonary artery reconstruction should not be influenced by the future surgical risk during the replacement procedure.
BACKGROUND: NCT03048071 . Registered 9 February 2017 (retrospectively registered).
METHODS: From 1999 to 2016, 82 children underwent 87 right ventricle to pulmonary artery conduit replacements (60 Contegra® and 27 homografts). Demographics, operative and clinical data were obtained through a retrospective review of the medical records. The two groups were matched for comparison using propensity score matching. All the procedures were performed by the same team of surgeons.
RESULTS: No statistically significant difference was observed between the two groups when considering the operative data for anesthesia, surgery, cardiopulmonary bypass and aortic clamping durations. A peroperative complication rate of 13.47% and 15.36% in Contegra® and homograft replacement groups respectively (p value = 0.758) was observed. There was no difference regarding the blood loss and fluid input. No statistically significant difference was observed between the two groups for the post-operative morbidity. We considered the Pediatric Risk of Mortality (PRISM) score, the day of extubation, the day of withdrawal of inotropic drugs, the length of the intensive care unit stay and the length of hospital stay. The overall mortality is 2.3% but there is no statistically significant difference between the two groups.
CONCLUSIONS: Right ventricle to pulmonary artery conduit replacement procedure can be achieved with a low surgical morbidity or mortality, not influenced by the type of conduit that is replaced. Therefore, the choice between homograft or Contegra® for right ventricle to pulmonary artery reconstruction should not be influenced by the future surgical risk during the replacement procedure.
BACKGROUND: NCT03048071 . Registered 9 February 2017 (retrospectively registered).
摘要：
背景：涉及右心室流出道的先天性心脏缺损的修复可能需要植入右心室至肺动脉导管。这种管道很可能在童年时期被更换。这项研究比较了Contegra®和同种移植在肺部位置的置换手术的手术结果。
方法：从1999年到2016年，82名儿童接受了87例右心室至肺动脉导管置换（60例Contegra®和27例同种异体移植）。人口统计,手术和临床数据是通过对病历的回顾性审查获得的.使用倾向评分匹配对两组进行比较。所有手术均由同一外科医生团队进行。
结果：在考虑麻醉的手术数据时，两组之间没有观察到统计学上的显着差异，手术,体外循环和主动脉阻断持续时间。在Contegra®和同种异体移植替代组中，围手术期并发症发生率分别为13.47％和15.36％（p值=0.758）。关于失血和液体输入没有差异。两组术后发病率无统计学差异。我们考虑了儿科死亡率风险(PRISM)评分，拔管的那一天,停用正性肌力药物的那一天，重症监护室住院时间和住院时间。总死亡率为2.3％，但两组之间无统计学差异。
结论：右心室至肺动脉导管置换手术可以实现低的手术发病率或死亡率，不受更换的导管类型的影响。因此,选择同种异体移植还是Contegra®用于右心室至肺动脉重建不应受到置换手术期间未来手术风险的影响.
背景：NCT03048071。2017年2月9日注册（追溯注册）。
方法：从1999年到2016年，82名儿童接受了87例右心室至肺动脉导管置换（60例Contegra®和27例同种异体移植）。人口统计,手术和临床数据是通过对病历的回顾性审查获得的.使用倾向评分匹配对两组进行比较。所有手术均由同一外科医生团队进行。
结果：在考虑麻醉的手术数据时，两组之间没有观察到统计学上的显着差异，手术,体外循环和主动脉阻断持续时间。在Contegra®和同种异体移植替代组中，围手术期并发症发生率分别为13.47％和15.36％（p值=0.758）。关于失血和液体输入没有差异。两组术后发病率无统计学差异。我们考虑了儿科死亡率风险(PRISM)评分，拔管的那一天,停用正性肌力药物的那一天，重症监护室住院时间和住院时间。总死亡率为2.3％，但两组之间无统计学差异。
结论：右心室至肺动脉导管置换手术可以实现低的手术发病率或死亡率，不受更换的导管类型的影响。因此,选择同种异体移植还是Contegra®用于右心室至肺动脉重建不应受到置换手术期间未来手术风险的影响.
背景：NCT03048071。2017年2月9日注册（追溯注册）。
