2017 Volume 33 Issue 2 Pages 163-168
Background: We use autologous tissue (AT) for the posterior wall during repair of the right ventricular outflow tract (RVOTR) whenever possible during biventricular repair (BVR) in infants with pulmonary atresia with ventricular septal defect (PAVSD).
Methods: This study included 18 patients who underwent BVR for PAVSD by age 3 at our institute between 1996 and 2015. Patients were divided into groups of 12 and 6 who underwent RVOTR using AT as the posterior wall of the RVOT (Group A) and an expanded polytetrafluoroethylene conduit (Group C), respectively.
Results: Rates of freedom from reoperation and re-intervention tended to be higher in Group A than C (reoperation at 5 and 10 years, 72.7％ vs 62.5％ and 72.7％ vs 0％, respectively; re-intervention at 1 and 3 years, 63.6％ vs 50.0％ and 36.4％ vs 16.7％, respectively; p＝0.35 and p＝0.16, respectively; hazard ratio [HR], both 0.47). Postoperative pulmonary artery stenosis was treated by balloon dilation in Group A (10 times for 12 lesions) and Group C (10 times for 14 lesions). The ratio of right ventricular/left ventricular peak systolic pressure (RVP/LVP) did not significantly differ before and after treatment in both groups. The RVP/LVP significantly decreased among patients who did not undergo reoperation in Group A (6 times for 8 lesions; p＝0.001).
Conclusions: Applying RVOTR with AT as the posterior wall of the RVOT for BVR in infants with PAVSD may postpone the need for reoperation.
