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Đánh giá kĩ thuật xẻ vòng van động mạch phổi giới hạn trong phẫu thuật sửa chữa tứ chứng Fallot
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Abstract
Objectives: Total correction of ToF with severe hypoplasia of pulmonary annulus (PA) require transannular patch (TAP), caused pulmonary insufficience (PI) and right ventricular (RV) dilatation. We practice the strategy restrictive enlargement of the PA of ToF repair and review the results of this technique. Methods: 327 ToF patients were conducted in the study, including 165 cases of PA preservation (50.5%), 66 patients of restrictive TAP (20.2%) and 90 cases of extended TAP (29.3%). Clinical, echocardiographic data and operative outcomes were analysed, especially focused on PI complication during follow-up.1 Results: 49.5% of ToF patients requires TAP. It increases the surgery duration: longer aortic crossclamp time, cardiopulmonary bypass time as well as longer ventication time and ICU stay, p < 0.001. After 1 year follow-up, the extended TAP group has more PI complication (71.7%) and more RV dilatation (33.3%), the restrictive TAP group shows a sastisfactory results of repair, reduces significantly PI complication and does not increase the significant residual pulmonary stenosis.
Conclusions: Restrictive enlargement of PA during ToF repair shows good outcomes and limits postoperative PI complication after one year follow-up.
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Keywords
Tetralogy of Fallot, Transannular patch, Restrictive Enlargement, Pulmonary Insufficiency
References
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