摘要
目的评价法洛四联症根治术后患者行外科肺动脉瓣置换术的中期效果。方法纳入2010年1月至2020年1月于我院接受外科肺动脉瓣置换术的法洛四联症术后患者73例,其中男42例、女31例。行法洛四联症根治术时中位年龄为3.9(0.2~42.8)岁,行肺动脉瓣置换术时中位年龄为20.0(2.0~50.0)岁。记录并分析患者的临床资料。结果术后30 d内无死亡患者。平均随访(35.6±28.5)个月,随访期间无死亡病例,1例患者接受再次肺动脉瓣置换术。全部患者1年、5年累积生存率均为100.0%,1年、5年免于再次手术率均为100.0%,1年、5年免于瓣膜衰败率分别为100.0%、67.1%。不同年龄组(P=0.49)和不同瓣膜类型组(P=0.74)患者免于瓣膜衰败率差异无统计学意义。术后患者右心室射血分数(P=0.006)及左心室射血分数(P=0.002)均得到改善,心电图所示QRS时间缩短(P=0.006)。结论外科肺动脉瓣置换术的中期效果良好,远期结果是下一步临床研究的重点。
Objective To evaluate mid-term outcomes of pulmonary valve replacement surgery after repair of tetralogy of Fallot.Methods A total of 73 patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement surgery in our hospital from January 2010 to January 2020 were enrolled,including 42 males and 31 females.The median age was 3.9(0.2-42.8)years at initial repair and 20.0(2.0-50.0)years at pulmonary valve replacement.The clinical data of the patients were recorded and analyzed.Results There was no death in postoperative 30 d.The average follow-up time was 35.6±28.5 months,and no death occurred during the follow-up.One patient underwent a second reintervention after initial pulmonary valve replacement.The 1-and 5-year survival rates were both 100.0%,the 1-and 5-year reintervention-free rates were both 100.0%,and the 1-and 5-year valve failure-free rates were 100.0%and 67.1%.There was no significant difference in valve failure-free rates between different age groups(P=0.49)and different type of valve groups(P=0.74).The right(P=0.006)and left(P=0.002)ventricular ejection fractions were significantly improved,and the QRS duration was shortened after pulmonary valve replacement(P=0.006).Conclusion Mid-term outcomes of surgical pulmonary valve replacement were satisfactory in patients with repaired tetralogy of Fallot,while the long-term effects should be further emphasized in clinical practice.
作者
赵栋
杨克明
李守军
ZHAO Dong;YANG Keming;LI Shoujun(Department of Cardiac Surgery,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Beijing Union Medical College,Chinese Academy of Medical Sciences,100037,Beijing,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第4期404-408,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家重点研发计划资助(2017YFC1308100)。
关键词
肺动脉瓣置换
法洛四联症
瓣膜衰败
再次手术
Pulmonary valve replacement
tetralogy of Fallot
valve failure
reintervention
