UNASSIGNED: A retrospective chart review between 2005 and 2017 on neonates with sTOF who underwent initial BPV from 9 participating centers of the Congenital Cardiac Research Collaborative was performed. Primary outcome was CR at >30 days after BPV without interval reintervention (RI).
UNASSIGNED: In total, 47 neonates with sTOF underwent BPV, of whom 27 (57%) underwent CR at >30 days after BPV without RI. The median time to CR was 151 days (106-210). RI before CR occurred in 17 patients (36%): surgical shunt (n = 7), outflow tract stenting (n = 6), patent ductus arteriosus stenting (n = 2), and surgical outflow patch (n = 2). Valve-sparing repair at CR was performed in 6 patients (13%) after initial BPV. RI or CR ≤30 days from BPV was associated with smaller infundibular diastolic diameter (P = .004). An infundibular diastolic diameter of <3.4 mm demonstrated 75% sensitivity and 67% specificity to predict early CR or RI.
UNASSIGNED: BPV can be an effective palliative therapy in select neonates with sTOF to delay CR. A smaller diastolic infundibulum diameter is a predictor of RI or early CR, and valve-sparing repair is uncommon, making patient selection and alternative palliative methods key when considering BPV palliation in neonates with sTOF.
■2005年至2017年期间,对9个参与先天性心脏研究合作中心的sTOF新生儿进行了回顾性图表回顾。主要结果是无间隔再干预(RI)的BPV后>30天的CR。
■总共,47例sTOF新生儿接受BPV,其中27人(57%)在无RI的BPV后>30天接受CR。达到CR的中位时间为151天(106-210)。17例患者发生CR前RI(36%):手术分流(n=7),流出道支架置入术(n=6),动脉导管未闭支架术(n=2),和手术流出补片(n=2)。初次BPV后,有6例患者(13%)在CR时进行了瓣膜保留修复。从BPV开始的RI或CR≤30天与较小的漏斗舒张直径相关(P=.004)。漏斗状舒张直径<3.4mm表明预测早期CR或RI的敏感性为75%,特异性为67%。
■BPV在选择sTOF的新生儿中可以是一种有效的姑息治疗,以延迟CR。较小的舒张漏斗直径是RI或早期CR的预测因子,保留瓣膜的修复并不常见,考虑sTOF新生儿BPV缓解时,选择患者和其他姑息治疗方法至关重要。