Zhang Hui-Feng, Chen Gang, Ye Ming, Yan Xian-Gang, Tao Qi-Lin, Jia Bing
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
J Thorac Dis. 2017 May;9(5):1234-1239. doi: 10.21037/jtd.2017.05.02.
Bovine jugular vein (BJV) conduits are widely applied for surgical reconstruction of the right ventricular outflow tract (RVOT). However, relevant studies of valve failure rates and the related risk factors are limited in China. The aim of this study was to assess the BJV prognosis after medium- to long-term follow-up.
Fifty-three hospital patients implanted with BJV conduits from January 2002 to December 2013 were recruited. Patient information and follow-up prognosis were reviewed retrospectively. Conduit stenosis and failure as well as endocarditis were diagnosed.
The total person years was 345.5, and the median follow-up time was 6.3 years. Early mortality occurred in two patients, and there was no late mortality. BJV conduit failure occurred in 15 patients (29.4%) due to severe stenosis (n=10), stenosis plus regurgitation (n=3), and regurgitation alone (n=2). The proportion of patients who were free of BJV conduit failure at 1, 3, 5, and 7 years was 98.0%, 85.8%, 76.8%, and 62.1%, respectively. There were nine cases of endocarditis (17.0%). Multivariate logistic regression analysis showed that endocarditis was a significant risk factor associated with BJV conduit failure (OR: 6.735; 95% CI: 1.348-33.647).
The durability of BJV conduits was suboptimal after a mid-term follow-up period. Endocarditis was found to be a significant risk factor that accelerates BJV conduit deterioration.
牛颈静脉(BJV)导管广泛应用于右心室流出道(RVOT)的外科重建。然而,在中国,关于瓣膜故障率及相关危险因素的研究有限。本研究旨在评估BJV导管中长期随访后的预后情况。
招募了2002年1月至2013年12月期间植入BJV导管的53例住院患者。回顾性分析患者信息及随访预后情况。诊断导管狭窄、衰竭以及心内膜炎。
总人年数为345.5,中位随访时间为6.3年。2例患者发生早期死亡,无晚期死亡。15例患者(29.4%)发生BJV导管衰竭,原因包括严重狭窄(n = 10)、狭窄伴反流(n = 3)和单纯反流(n = 2)。1年、3年、5年和7年无BJV导管衰竭的患者比例分别为98.0%、85.8%、76.8%和62.1%。发生心内膜炎9例(17.0%)。多因素logistic回归分析显示,心内膜炎是与BJV导管衰竭相关的显著危险因素(OR:6.735;95%CI:1.348 - 33.647)。
中期随访后,BJV导管的耐久性欠佳。心内膜炎是加速BJV导管恶化的显著危险因素。