PDF(Pubmed)
Abstract：
UNASSIGNED: Both systemic-to-pulmonary shunt and right ventricle-pulmonary artery (RV-PA) connection are extensively applied to initially rehabilitate the pulmonary artery in pulmonary atresia with the ventricle septal defect (PA/VSD). However, which of these options is the most ideal for promoting pulmonary artery development and improving outcomes remains controversial.
UNASSIGNED: A total of 109 PA/VSD patients undergoing initial rehabilitative surgery at Guangdong Provincial People\'s Hospital from 2010 to 2020 were enrolled in this study. A series of clinical data were collected to compare the perioperative and postoperative outcomes between systemic-to-pulmonary and RV-PA connection.
UNASSIGNED: The mean duration of follow-up was 61.1 months in the systemic-to-pulmonary shunt group and 70.3 months in the RV-PA connection group (p > 0.05). The RV-PA connection technique resulted in a significantly higher PaO 2 , lower red blood cells (RBC), lower hemoglobin, and lower hematocrit (Hct) (p < 0.05). The cumulative incidence curve estimated a cumulative complete repair rate of 56 ± 7% after 5 years in the RV-PA connection group, significantly higher than 36 ± 7% after 5 years in the systemic-to-pulmonary shunt group (p < 0.05). The Kaplan-Meier curve revealed a similar estimated survival rate between the two groups (p = 0.73). The RV-PA connection was identified as an independent predictor for complete repair in the multivariable analysis (HR = 2.348, 95% CI = 1.131-4.873).
UNASSIGNED: The RV-PA connection is a more ideal initial rehabilitative technique than systemic-to-pulmonary shunt in treating PA/VSD as a consequence of comparable probability of survival but improved definitive complete repair rate.
UNASSIGNED: A total of 109 PA/VSD patients undergoing initial rehabilitative surgery at Guangdong Provincial People\'s Hospital from 2010 to 2020 were enrolled in this study. A series of clinical data were collected to compare the perioperative and postoperative outcomes between systemic-to-pulmonary and RV-PA connection.
UNASSIGNED: The mean duration of follow-up was 61.1 months in the systemic-to-pulmonary shunt group and 70.3 months in the RV-PA connection group (p > 0.05). The RV-PA connection technique resulted in a significantly higher PaO 2 , lower red blood cells (RBC), lower hemoglobin, and lower hematocrit (Hct) (p < 0.05). The cumulative incidence curve estimated a cumulative complete repair rate of 56 ± 7% after 5 years in the RV-PA connection group, significantly higher than 36 ± 7% after 5 years in the systemic-to-pulmonary shunt group (p < 0.05). The Kaplan-Meier curve revealed a similar estimated survival rate between the two groups (p = 0.73). The RV-PA connection was identified as an independent predictor for complete repair in the multivariable analysis (HR = 2.348, 95% CI = 1.131-4.873).
UNASSIGNED: The RV-PA connection is a more ideal initial rehabilitative technique than systemic-to-pulmonary shunt in treating PA/VSD as a consequence of comparable probability of survival but improved definitive complete repair rate.
摘要：
■体肺分流术和右心室-肺动脉（RV-PA）连接均广泛用于最初修复伴有室间隔缺损（PA/VSD）的肺动脉闭锁。然而,这些选择中哪一种最适合促进肺动脉发育和改善预后仍存在争议.
■本研究共纳入广东省人民医院2010年至2020年初次康复手术的109例PA/VSD患者。收集了一系列临床数据，以比较体肺和RV-PA连接的围手术期和术后结局。
■体肺分流术组的平均随访时间为61.1个月，RV-PA连接组为70.3个月（p>0.05）。RV-PA连接技术导致明显更高的PaO2，较低的红细胞（RBC），低血红蛋白，和较低的血细胞比容(Hct)(p<0.05)。累积发生率曲线估计RV-PA连接组5年后的累积完全修复率为56±7%，5年后，体肺分流组显著高于36±7%(p<0.05)。Kaplan-Meier曲线显示两组之间的估计生存率相似（p=0.73）。在多变量分析中，RV-PA连接被确定为完全修复的独立预测因子（HR=2.348，95％CI=1.131-4.873）。
■与体肺分流术相比，RV-PA连接是治疗PA/VSD的更理想的初始康复技术，其结果是生存概率相当，但最终完全修复率提高。
■本研究共纳入广东省人民医院2010年至2020年初次康复手术的109例PA/VSD患者。收集了一系列临床数据，以比较体肺和RV-PA连接的围手术期和术后结局。
■体肺分流术组的平均随访时间为61.1个月，RV-PA连接组为70.3个月（p>0.05）。RV-PA连接技术导致明显更高的PaO2，较低的红细胞（RBC），低血红蛋白，和较低的血细胞比容(Hct)(p<0.05)。累积发生率曲线估计RV-PA连接组5年后的累积完全修复率为56±7%，5年后，体肺分流组显著高于36±7%(p<0.05)。Kaplan-Meier曲线显示两组之间的估计生存率相似（p=0.73）。在多变量分析中，RV-PA连接被确定为完全修复的独立预测因子（HR=2.348，95％CI=1.131-4.873）。
■与体肺分流术相比，RV-PA连接是治疗PA/VSD的更理想的初始康复技术，其结果是生存概率相当，但最终完全修复率提高。
