Li Wenlei,Bi Jiachen,Zhou Na,et al.Middle-to-long-term outcomes of bovine jugular vein valve tubing for reconstructing right ventricular outflow tract in children[J].Journal of Clinical Pediatric Surgery,,():835-840.[doi:10.3760/cma.j.cn101785-202506039-006]
Middle-to-long-term outcomes of bovine jugular vein valve tubing for reconstructing right ventricular outflow tract in children
- Keywords:
- Pulmonary Valve; Heart Diseases; Ventricular Dysfunction; Right; Anesthesia; Cardiac Procedures; Child
- Abstract:
- Objective In recent years, bovine jugular vein valvular conduits (BJVC) have become one of the optional materials for reconstructing right ventricular outflow tract (RVOT) in children with complex congenital heart disease (CHD).This paper attempted to summarize the middle-to-long-term follow-up outcomes of BJVC reconstruction for pediatric RVOT. Methods A retrospective analysis was conducted for the relevant clinical data of 110 children with complex CHD undergoing reconstruction of RVOT using BJVC under extracorporeal circulation from June 2017 to December 2024.Tube sizes, perioperative profiles and postoperative ultrasonic results were recorded.Kaplan-Meier method was employed for calculating the rates of no functional impairment and non-reoperation. They were grouped according to the diameter of tubes 12-14 mm and 15-17 mm, as well as operative age ≤12 month and operative age >12 month.The rates of non-reoperation were compared between each subgroup. Results Among 110 children with complex CHD, there were 52 boys and 58 girls with an age range of 19(7, 40.75) month and a body weight of (10.6±7.0) kg.Pulmonary artery occlusion with ventricular septal defect was a major disease using BJVC (87/110, 79.1%).During a median follow-up period of 55 month, there were early death (n=5) and losing to long-term follow-ups (n=17, including 5 cases of late death).Among 88 cases undergoing postoperative follow-up assessments, 50 cases of varying degrees of conduit dysfunction occurred cumulatively with the highest proportion of conduit stenosis (40/88, 45.5%).There were pipeline blockage (n=2) and infective endocarditis (n=5) and moderate or above reflux (n=3).The rates of 1/3/5-year conduit dysfunction were 96.6%, 87.2% and 59.6%.And 33 cases underwent conduit replacement with a 1/3/5-year non-surgical rate of 95.4%, 85.1% and 69.1%, respectively.Size of implanted tube and operative age were not significant factors affecting reoperation (P>0.05). Conclusions BJVC is one of the ideal implant materials for reconstructing RVOT in children with complex CHD, providing early decent durability and hemodynamic function.In addition to the risk of infective endocarditis, middle-to-long-term functional impairment rate of BJVC remains relatively high with stenosis as a major manifestation.And reoperation rate is also relatively high.
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Memo
收稿日期:2025-6-17。
基金项目:广州市科技计划项目(2024A03J1165)
通讯作者:马力，Email: lima163@163.com