Department of Cardiothoracic Surgery, 501944Narayana Institute of Cardiac Sciences, Narayana Health, Bangalore, Karnataka, India.
Department of Pediatric Cardiology, 501944Narayana Institute of Cardiac Sciences, Narayana Health, Bangalore, Karnataka, India.
World J Pediatr Congenit Heart Surg. 2022 May;13(3):334-340. doi: 10.1177/21501351221077888.
The aim of this study was to review our institutional experience with patients who underwent surgical repair of aortopulmonary window, either as an isolated lesion or in association with other cardiac anomalies. Between January 2006 and December 2020, 183 patients underwent surgical repair of aortopulmonary window at our institute. Sixty-three patients had associated lesions (Group 1); 120 patients had isolated aortopulmonary window (Group 2). Median age was 7 months. The early mortality in Group 1 was significantly higher (12.7%) compared to Group 2 (0.8%) ( = .001). The most common associated anomaly was ventricular septal defect (29 patients). On univariable analysis, cardiopulmonary bypass time ( < .001), aortic cross-clamp time ( < .001), delayed chest closure ( = .02), sepsis ( = .006), tracheostomy ( = .002), extracorporeal membrane oxygenation ( < .001), associated lesions ( = .001), pulmonary artery hypertensive crisis ( < .001) were predictors for early mortality. On multivariable analysis only pulmonary artery hypertensive crisis was identified as predictor for early mortality ( = .03; odds ratio = 24). Survival at both 5 years and 8 years was 77% ± 6.5 in Group 1 and 98.8% ± 1.2 in Group 2 (≤.001). Freedom from reintervention at both 5 years and 8 years was 92.4% ± 5.2 in Group 1 and 100% in Group 2 ( = .055). Early outcomes of aortopulmonary window repair are excellent among patients in which this is an isolated lesion, as compared to those with associated lesions. Long-term outcomes in terms of freedom from reoperation are excellent in both the groups.
本研究旨在回顾我院接受主动脉肺动脉窗手术修复的患者的临床经验，这些患者的病变为孤立性或合并其他心脏畸形。2006 年 1 月至 2020 年 12 月，我院共对 183 例主动脉肺动脉窗患者进行了手术修复。其中 63 例合并其他病变（第 1 组）；120 例为单纯主动脉肺动脉窗（第 2 组）。中位年龄为 7 个月。第 1 组的早期死亡率明显高于第 2 组（12.7%比 0.8%）（ = .001）。最常见的合并畸形是室间隔缺损（29 例）。单变量分析显示，体外循环时间（ < .001）、主动脉阻断时间（ < .001）、延迟关胸（ = .02）、败血症（ = .006）、气管切开术（ = .002）、体外膜肺氧合（ < .001）、合并病变（ = .001）、肺动脉高压危象（ < .001）是早期死亡的预测因素。多变量分析仅发现肺动脉高压危象是早期死亡的预测因素（ = .03；比值比 = 24）。第 1 组 5 年和 8 年生存率分别为 77%±6.5，第 2 组为 98.8%±1.2（≤.001）。第 1 组 5 年和 8 年无再干预率分别为 92.4%±5.2，第 2 组为 100%（ = .055）。孤立性病变患者主动脉肺动脉窗修复的早期结果优于合并病变患者。两组患者的长期免于再次手术的结果均良好。
