Hospital Pequeno Príncipe, Pontificia Universidade Católica Paraná, Curitiba, PR, Brazil.
Arq Bras Cardiol. 2011 Jan;96(1):2-7. doi: 10.1590/s0066-782x2010005000158. Epub 2010 Dec 10.
The pulmonary homograft has been used as an option in the correction of congenital cardiopathy with obstruction of the right ventricle exit tract. The long term results, however, are little satisfactory.
Identify the risk factors associated to the dysfunction and the pulmonary homograft failure.
Study with children submitted to the enlargement of the exit tract of the right ventricle with pulmonary homograft. The clinical, surgical, evolutional and morphological aspects of the prosthesis variables were analyzed as risk factors.
The final sample of 75 patients with median age at the surgery of 22 months, varying from 1-157 months, presented 13 patients (17.0%) who developed dysfunction of the homograft, characterized by stenosis or severe pulmonary insufficiency. The occurrence time between the homograft implant and the detection of the dysfunction was of 45 ± 20 months. When the size of the homograft was smaller than 21 mm and the Z score of the pulmonary valva is lower than zero, or higher than three, the risk factors were considered for the dysfunction occurrence.
The pulmonary homograft smaller than 21 mm and the inadequate pulmonary valva for the age and weight of the patient are determining factors for the prosthesis dysfunction.
同种肺动脉瓣被用作右心室流出道梗阻性先天性心脏病矫正的一种选择。然而，长期结果并不令人满意。
确定与同种肺动脉瓣功能障碍和衰竭相关的风险因素。
对接受同种肺动脉瓣扩大右心室流出道的儿童进行研究。分析了假体变量的临床、手术、演变和形态学方面作为风险因素。
最终的 75 名患者样本中位手术年龄为 22 个月，范围为 1-157 个月，其中 13 名（17.0%）患者出现同种肺动脉瓣功能障碍，表现为狭窄或严重的肺动脉瓣关闭不全。同种肺动脉瓣植入与功能障碍检测之间的时间间隔为 45 ± 20 个月。当同种肺动脉瓣瓣环小于 21mm，且肺动脉瓣 Z 值小于 0 或大于 3 时，认为这些因素是同种肺动脉瓣功能障碍发生的危险因素。
小于 21mm 的同种肺动脉瓣和与患者年龄和体重不匹配的肺动脉瓣是导致假体功能障碍的决定因素。
