Department of Pediatric Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
J Card Surg. 2021 Sep;36(9):3147-3152. doi: 10.1111/jocs.15683. Epub 2021 May 30.
To describe our short- and medium-term outcomes using the BioIntegral pulmonic conduit.
Between August 2018 and September 2019, the BioIntegral pulmonic valved conduit was used for right ventricular outflow tract reconstruction in 48 patients. The data were retrospectively retrieved from the patient charts.
The median age at surgery was 36 months (interquartile range [IQR] = 18-62 months). The diagnoses were pulmonary atresia-ventricular septal defect in 28 patients, absent pulmonary valve in four patients, truncus arteriosus in six patients, TGA-VSD-PS in five patients, conduit stenosis in three patients, and left venticular outflow tract obstruction requiring a Ross operation in two patients. In the postoperative short-term follow-up, 15 patients out of 48 had a high fever. Of these, 12 patients had concomitantly elevated C-reactive protein levels. There were no patients with blood culture positivity. The median postoperative length of hospital stay was 14 days (IQR = 8-21 days). The overall mortality was 4% in two patients, one died of right ventricular failure and multiple organ failure and one died of pulmonary embolism. The two patients who died were not among the 15 patients with fever. However, four patients with fever underwent balloon angioplasty for conduit restenosis in their medium-term follow-up.
There was a high incidence of fever and adverse outcomes in the short-term postoperative follow-up of patients in whom the BioIntegral pulmonic valved conduit was implanted. Caution is advisable in using these conduits until there is convincing evidence about the sterilization and storage standards of these grafts.
描述我们使用 BioIntegral 肺动脉带瓣管道的短期和中期结果。
在 2018 年 8 月至 2019 年 9 月期间，我们使用 BioIntegral 肺动脉带瓣管道为 48 例患者进行了右心室流出道重建。数据从患者病历中回顾性获取。
手术时的中位年龄为 36 个月（四分位距 [IQR] = 18-62 个月）。诊断为肺动脉瓣闭锁伴室间隔缺损 28 例，肺动脉瓣缺如 4 例，共同动脉干 6 例，大动脉转位伴室间隔缺损及肺动脉瓣狭窄 5 例，管道狭窄 3 例，左心室流出道梗阻需行 Ross 手术 2 例。术后短期随访中，48 例患者中有 15 例出现高热。其中，12 例患者同时伴有 C 反应蛋白水平升高。无血培养阳性患者。术后中位住院时间为 14 天（IQR = 8-21 天）。总死亡率为 4%，2 例死亡，1 例死于右心衰竭和多器官衰竭，1 例死于肺栓塞。死亡的 2 例患者不在发热的 15 例患者中。然而，4 例发热患者在中期随访中因管道再狭窄行球囊血管成形术。
植入 BioIntegral 肺动脉带瓣管道的患者在术后短期随访中高热和不良结局的发生率较高。在有令人信服的证据证明这些移植物的消毒和储存标准之前，使用这些管道应谨慎。
