Abstract：
The objective of this study was to evaluate and compare the results of the modified réparation à l\'ètage ventriculaire (REV) and the Rastelli operation for the treatment of transposition of the great arteries (TGA), ventricular septal defect (VSD), and pulmonary stenosis (PS). Records of 38 patients who underwent the modified REV (n = 16) or the Rastelli operation (n = 22) for the treatment of TGA, VSD, and PS between 2010 and 2019 were reviewed. The median age was 2.2 years (range 0.6-8.0 years) and the median weight was 11.3 kg (range 6.4-22.0 kg). No in-hospital death occurred and there were 4 early reoperations (two in each group). Overall survival at 10 years was 97.4% (100% in Modified REV group and 95.5% in Rastelli group, P = 0.39). Freedom from left ventricular outflow tract (LVOT) reoperation was 100% in both groups. Freedom from right ventricular outflow tract (RVOT) reoperation was 100% in Modified REV group and 75.4% in Rastelli group (P = 0.073). Event-free survival was 100% in Modified REV group and 72.0% in Rastelli group (P = 0.048). The most recent echocardiography showed that LVOT peak gradient was less than 10 mmHg in all patients. In Modified REV group, 30.8% of patients (4/13) had either RVOT obstruction (RVOT peak gradient more than 40 mmHg) or moderate or severe pulmonary insufficiency, while conduit stenosis (peak gradient more than 40 mmHg) was found in 25.0% of patients (3/12) in Rastelli group. The modified REV and the Rastelli operation provide satisfactory early results, as well as long-term survival and LVOT performance. However, the modified REV has better RVOT performance.
摘要：
这项研究的目的是评估和比较改良的脑室（REV）和Rastelli手术治疗大动脉转位（TGA）的结果，室间隔缺损(VSD),和肺动脉狭窄（PS）。记录了38例接受改良REV（n=16）或Rastelli手术（n=22）治疗TGA的患者，VSD,并对2010年至2019年的PS进行了审查。中位年龄为2.2岁（范围0.6-8.0岁），中位体重为11.3kg（范围6.4-22.0kg）。没有发生院内死亡，有4例早期再次手术（每组2例）。10年总生存率为97.4%（改良REV组为100%，Rastelli组为95.5%，P=0.39）。两组的左心室流出道（LVOT）再手术自由度均为100％。改良REV组无右室流出道（RVOT）再手术率为100％，Rastelli组为75.4％（P=0.073）。改良REV组无事件生存率为100%，Rastelli组为72.0%（P=0.048）。最近的超声心动图显示，所有患者的LVOT峰值梯度均小于10mmHg。在ModifiedREV组中，30.8％的患者（4/13）患有RVOT梗阻（RVOT峰值梯度超过40mmHg）或中度或重度肺功能不全，而Rastelli组有25.0%(3/12)的患者发现导管狭窄(峰值梯度大于40mmHg)。改良的REV和Rastelli手术提供了令人满意的早期结果，以及长期生存和LVOT性能。然而,改进的REV具有更好的RVOT性能。
