Role of Surgery on Growth of Tricuspid Valve in Pulmonary Atresia with Intact Ventricular Septum:Mid-Term Results of Modified Right-Ventricular Overhauling Procedure

作     者：Jae Gun Kwak Eung Re Kim Taeyoung Yun Sungkyu Cho Chang-Ha Lee Woong-Han Kim 

作者机构：Department of Thoracic and Cardiovascular SurgerySeoul National University Children’s HospitalCollege of MedicineSeoul National UniversitySeoulKorea 2Department of Thoracic and Cardiovasclar SurgerySejong General HospitalBucheonGyeonggiKorea 

出 版 物：《Congenital Heart Disease》 (先天性心脏病（英文）)

年 卷 期：2023年第18卷第3期

页      面：325-336页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Congenital heart disease cyanotic heart disease pulmonary atresia with intact ventricular septum right ventricular overhauling 

摘      要：Objectives:To access the effectiveness of our modified right-ventricular overhauling procedure on tricuspid valve(TV)growth in patients with pulmonary atresia with intact ventricular septum(PAIVS).Methods:We retrospectively reviewed 21 patients with PAIVS who underwent modified right ventricular overhauling(mRVoh)between 2008 and 2019 at two *** mRVoh consisted of wide resection of hypertrophied infundibular and trabecular muscle,peeling off fibrotic endocardial tissue in the right ventricle(RV)cavity,surgical pulmonary valvotomy,and Blalock-Taussig shunt or banding of ductus arteriosus under cardiopulmonary *** TV annulus sizes were measured and analyzed using echocardiography before and after ***:No mortalities were observed during a median follow-up of 3 years(interquartile range:1.3–4.7 years)of follow-up were *** was performed at a median age of 163.5 days(range:21–560 days),including seven neonates and two infants(60 days).During follow-up,the median TV annular z-score increased significantly from−2.24 to−1.15 before and after mRVoh(p=0.004).In ten patients with a prior history of percutaneous interventions for RV outflow tract(RVOT)widening at least 6 months before mRVoh,the TV annular z-score significantly changed during the period after mRVoh(−2.03 to−1.61,p=0.028)compared with the period before mRVoh(−2.51→–2.03,p=0.575)after percutaneous intervention ***:mRVoh in PAIVS patients was positively associated with TV annular growth,and it was more effective than percutaneous RVOT widening interventions without mRVoh.