UNASSIGNED: For infants requiring repair for type I and II truncus arteriosus, the truncal root was septated through a hockey stick incision keeping the branch pulmonary arteries in situ, the ventricular septal defect was closed, and a short aortic homograft was used to reconstruct the right ventricular outflow tract. Echocardiograms measured preoperative and follow-up branch pulmonary artery diameter.
UNASSIGNED: Between 1998 and 2020, 41 infants were repaired using the modified approach (type I, 28; type II, 13). With a median follow-up of 11.6 (interquartile range, 3.1-15.5) years, there was no significant change between preoperative left pulmonary artery and right pulmonary artery Z-scores and their corresponding follow-up measurement (left pulmonary artery: 0.97, interquartile range, 0.6-1.6 vs left pulmonary artery: 1.4, interquartile range, -0.3 to 1.9) (right pulmonary artery: 0.6, interquartile range, -0.4 to 1.7 vs right pulmonary artery: 0.3 interquartile range, 0.5-0.9). Only 7.3% (n = 2) of follow-up right pulmonary artery Z-scores were less than 2.5 Z-scores below preoperative measurements. Four children (9.8%) required early right ventricular outflow tract reoperation. On multivariable analysis, larger conduit Z-scores were associated with greater time to right ventricular outflow tract reoperation (hazard ratio, 0.55, confidence interval, 0.307-0.984; P = .043).
UNASSIGNED: Maintaining the branch pulmonary arteries in situ at initial truncus arteriosus repair allows for branch pulmonary arterial growth, limiting early right ventricular outflow tract reoperation.
未经批准:对于需要修复I型和II型动脉干的婴儿,通过曲棍球棒切口将躯干根部分开,使分支肺动脉保持在原位,室间隔缺损是闭合的,短主动脉移植用于重建右心室流出道。超声心动图测量术前和随访分支肺动脉直径。
未经评估:在1998年至2020年之间,使用改良方法修复了41名婴儿(I型,28;II型,13).中位随访时间为11.6(四分位数间距,3.1-15.5)年,术前左肺动脉和右肺动脉Z评分及其相应的随访测量值之间无明显变化(左肺动脉:0.97,四分位距,0.6-1.6vs左肺动脉:1.4,四分位数间距,-0.3至1.9)(右肺动脉:0.6,四分位数间距,-0.4至1.7vs.右肺动脉:0.3四分位数间距,0.5-0.9)。只有7.3%(n=2)的随访右肺动脉Z评分低于术前测量值2.5Z评分。四名儿童(9.8%)需要早期右心室流出道再次手术。在多变量分析中,较大的导管Z评分与较长的右心室流出道再手术时间相关(风险比,0.55,置信区间,0.307-0.984;P=0.043)。
未经授权:在初始动脉干修复时将分支肺动脉保持在原位允许分支肺动脉生长,限制早期右心室流出道再手术。