■将TOF修复的早期手术结果与RVOTO修复的三种当代修复策略,即TAP,TAP和肺动脉瓣修复中的单尖结构(MC)。
■研究在旁遮普心脏病研究所进行,拉合尔从2016年5月到2020年4月。根据肺动脉瓣环的z评分,在TOF手术期间通过三种不同的RVOT修复策略对接受TOF修复的患者进行数据回顾性分析。第一组接受了跨环形补片修复,而II组和III组分别进行了自体心包和肺动脉瓣修复的单尖修复。使用方差分析(ANOVA)和皮尔逊卡方(PCS)统计学分别比较三组的数字和分类变量。对数字数据进行事后t检验和Bonferroni校正,以比较两组。使用卡方检验对类别变量进行组间比较。
■主动脉阻断时间的方差分析,CPB总时间,术后机械通气时间,ICU住院时间和住院时间在所有三组之间均显示出统计学差异,p值小于0.05,但是事后T检验表明,这种差异仅在各组之间进行比较时才限于术后机械通气。PCS显示,当所有三组进行比较时,CPB的困难撤机发生率存在差异,而p值为0.15的手术死亡率没有差异。然而,第II组与第I组的比较显示,第II组的CPB断奶优于第I组,p值为0.016。第III组显示了所有三组中所有手术结果变量的最佳统计数据。比较II组和III组出院前术后中度肺返流的发生率,差异有统计学意义,p值为0.0052。
■如果可行,应采用PV修复策略进行TOF的RVOT修复。与TAP相比,MC修复显示术后机械通气时间较少,易断CPB的发生率较高,然而它对ICU逗留的影响,在我们的TOF修复人群中,住院时间和手术死亡率并不高。
UNASSIGNED: To compare the early operative outcome of TOF repair with three contemporary repair strategies of RVOTO repair i.e. TAP, Mono-cusp construction (MC) in TAP and pulmonary valve repair.
UNASSIGNED: Study is performed at Punjab Institute of Cardiology, Lahore from May 2016 to April 2020. Retrospective analysis of data was performed for patient who underwent TOF repair by three different strategies of RVOT repairs during TOF surgery based on z scoring for pulmonary valve annulus. Group-I underwent trans-annular patch repair, while Group-II and III underwent Mono-cusp repair with autologous pericardium and pulmonary valve repair respectively. Analysis of Variance (ANOVA) and Pearson Chi-Square (PCS) statistics were used to compare the three groups for numeric and categorical variables respectively. Post-hoc t-test and Bonferroni correction were performed for numeric data to compare two groups with each other. Chi-square test was used to perform comparison between groups for categorial variables.
UNASSIGNED: ANOVA for aortic cross clamp time, total CPB time, Post-operative mechanical ventilation time, ICU stay and hospital stay showed statistical difference among all three group with p-value less than 0.05 however post hoc T-test showed this variation is limited to post-operative mechanical ventilation only when groups compared with each other. PCS showed there was difference for incidence of difficult weaning from CPB when all three groups compared while there was no difference in operative mortality with p-value of 0.15. However, Group-II comparison with Group-I showed that weaning from CPB was superior in-Group-II with p-value of 0.016. Group-III showed the best statistics for all operative outcome variables among all three groups. Comparison of incidence of post-operative moderate pulmonary regurgitation before discharge between Group-II and Group-III showed significant difference with p-value of 0.0052.
UNASSIGNED: PV repair strategy should be employed for RVOT repair of TOF whenever feasible. MC repair showed fewer hours of postoperative mechanical ventilation and higher incidence of easy weaning from CPB when compared to TAP, however its impacts over ICU stay, Hospital stay and operative mortality is not profound in our TOF repair population.