Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot
Aim: assess of the pulmonary artery growth and the outcomes of complete repair after palliative treatment in infants with critical form of Tetralogy of Fallot.Methods. This was prospective randomized two-center study (2019 to 2022). Its included infants with Tetralogy of Fallot who underwent palliat...
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| Format: | Article |
| Language: | Russian |
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InterMedservice
2023-11-01
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| Series: | Евразийский Кардиологический Журнал |
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| Online Access: | https://www.heartj.asia/jour/article/view/6421 |
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| author | M. G. Morsina I. A. Soynov A. V. Voitov M. G. Pursanov Yu. Yu. Kulyabin N. R. Nichay A. V. Gorbatykh A. N. Arkhipov A. V. Bogachev-Prokofiev A. M. Chernyavskiy |
| author_facet | M. G. Morsina I. A. Soynov A. V. Voitov M. G. Pursanov Yu. Yu. Kulyabin N. R. Nichay A. V. Gorbatykh A. N. Arkhipov A. V. Bogachev-Prokofiev A. M. Chernyavskiy |
| author_sort | M. G. Morsina |
| collection | DOAJ |
| description | Aim: assess of the pulmonary artery growth and the outcomes of complete repair after palliative treatment in infants with critical form of Tetralogy of Fallot.Methods. This was prospective randomized two-center study (2019 to 2022). Its included infants with Tetralogy of Fallot who underwent palliation with either stenting of the right ventricular outflow tract (stent group, n=21) or modified Blalock-Taussig shunt (shunt group, n=21).Results. In the stent group Nakata index increase from median 104.2 to 208.6 mm2/m2, while in the shunt group, it increased from 107.3 to 169.4 mm2/m2 (p<0,01). Mixed model analysis showed that in stent group the right pulmonary artery growth rate was 2.05*10-2 z scores/day, which was 3.01 times higher than in the shunt group. In stent group the left pulmonary artery growth rate was 2.3*10-2 z scores/day, which was 1.47 times higher than in the shunt group. In the stent group, there was one noncardiac-related mortality during the intermediate period. Transannular patch repair of the right ventricular outflow tract was performed in 12 patients (60%) in the stent group and in 15 patients (71.4%) in the shunt group (p=0.52) during complete repair. At 8 cases (40%) in the stent group and 6 cases (28.6%) in the shunt group, pulmonary artery replacement was performed. Time to surgical repair was shorter in the stent group (p=0.046), while the aortic cross clamp time (p<0,01) and cardiopulmonary bypass time (p<0,01) were significantly shorter in the shunt group.Conclusions. Right ventricular outflow tract stenting provides hemodynamic stabilization and uniform growth of the pulmonary artery compared to modified Blalock-Taussig shunt. |
| format | Article |
| id | doaj-art-2ab2a94d997048d5b40bc7490ee42805 |
| institution | DOAJ |
| issn | 2225-1685 2305-0748 |
| language | Russian |
| publishDate | 2023-11-01 |
| publisher | InterMedservice |
| record_format | Article |
| series | Евразийский Кардиологический Журнал |
| spelling | doaj-art-2ab2a94d997048d5b40bc7490ee428052025-08-20T03:20:20ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482023-11-010461510.38109/2225-1685-2023-4-6-156318Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of FallotM. G. Morsina0I. A. Soynov1A. V. Voitov2M. G. Pursanov3Yu. Yu. Kulyabin4N. R. Nichay5A. V. Gorbatykh6A. N. Arkhipov7A. V. Bogachev-Prokofiev8A. M. Chernyavskiy9Meshalkin National Medical Research CenterMeshalkin National Medical Research CenterMeshalkin National Medical Research CenterMorozov Children’s Municipal Clinical Hospital of the Moscow City Health DepartmentMeshalkin National Medical Research CenterMeshalkin National Medical Research Center; Novosibirsk State Medical UniversityAlmazov National Medical Research CentreMeshalkin National Medical Research CenterMeshalkin National Medical Research CenterMeshalkin National Medical Research CenterAim: assess of the pulmonary artery growth and the outcomes of complete repair after palliative treatment in infants with critical form of Tetralogy of Fallot.Methods. This was prospective randomized two-center study (2019 to 2022). Its included infants with Tetralogy of Fallot who underwent palliation with either stenting of the right ventricular outflow tract (stent group, n=21) or modified Blalock-Taussig shunt (shunt group, n=21).Results. In the stent group Nakata index increase from median 104.2 to 208.6 mm2/m2, while in the shunt group, it increased from 107.3 to 169.4 mm2/m2 (p<0,01). Mixed model analysis showed that in stent group the right pulmonary artery growth rate was 2.05*10-2 z scores/day, which was 3.01 times higher than in the shunt group. In stent group the left pulmonary artery growth rate was 2.3*10-2 z scores/day, which was 1.47 times higher than in the shunt group. In the stent group, there was one noncardiac-related mortality during the intermediate period. Transannular patch repair of the right ventricular outflow tract was performed in 12 patients (60%) in the stent group and in 15 patients (71.4%) in the shunt group (p=0.52) during complete repair. At 8 cases (40%) in the stent group and 6 cases (28.6%) in the shunt group, pulmonary artery replacement was performed. Time to surgical repair was shorter in the stent group (p=0.046), while the aortic cross clamp time (p<0,01) and cardiopulmonary bypass time (p<0,01) were significantly shorter in the shunt group.Conclusions. Right ventricular outflow tract stenting provides hemodynamic stabilization and uniform growth of the pulmonary artery compared to modified Blalock-Taussig shunt.https://www.heartj.asia/jour/article/view/6421tetralogy of fallotpulmonary artery hypoplasiatwo-stage repairstenting of the right ventricular outflow tractmodified blalock-taussig shunt |
| spellingShingle | M. G. Morsina I. A. Soynov A. V. Voitov M. G. Pursanov Yu. Yu. Kulyabin N. R. Nichay A. V. Gorbatykh A. N. Arkhipov A. V. Bogachev-Prokofiev A. M. Chernyavskiy Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot Евразийский Кардиологический Журнал tetralogy of fallot pulmonary artery hypoplasia two-stage repair stenting of the right ventricular outflow tract modified blalock-taussig shunt |
| title | Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot |
| title_full | Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot |
| title_fullStr | Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot |
| title_full_unstemmed | Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot |
| title_short | Assessment of the pulmonary arterial growth and results of two-stage repair in infants with severe form of tetralogy of Fallot |
| title_sort | assessment of the pulmonary arterial growth and results of two stage repair in infants with severe form of tetralogy of fallot |
| topic | tetralogy of fallot pulmonary artery hypoplasia two-stage repair stenting of the right ventricular outflow tract modified blalock-taussig shunt |
| url | https://www.heartj.asia/jour/article/view/6421 |
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