Short-term outcome of polytetrafluoroethylene membrane valve versus transannular pericardial patch reconstruction of right ventricular outflow tract in tetralogy of fallot: a randomized controlled trial
Rev. bras. cir. cardiovasc
;
36(1): 39-47, Jan.-Feb. 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1155795
ABSTRACT
Abstract Introduction:
Reconstruction of right ventricular outflow tract during primary repair of tetralogy of Fallot often requires the placement of a transannular patch which results in pulmonary regurgitation (PR). We compared the short-term outcomes of bicuspid polytetrafluoroethylene membrane valve versus transannular pericardial patch reconstruction of the right ventricular outflow tract.Methods:
Thirty consecutive patients undergoing primary repair of tetralogy of Fallot were randomly allocated to two groups - polytetrafluoroethylene valve (PTFEV) group (n=15) and transannular pericardial patch (TAP) group (n=15). The two groups had similar preoperative demographic characteristics. We compared the short-term clinical and echocardiographic outcomes between these groups. The transthoracic echocardiographic follow-up was performed at one week, one month and six months after surgery.Results:
The PTFEV group had significantly lower central venous pressure in the immediate postoperative period compared to the TAP group (7.60±2.06 vs. 10.13±1.73, P=0.002). Extubation time was significantly shorter in the PTFEV group compared to the TAP group (12.93±7.55 hrs vs. 22.23±15.11 hrs, P=0.04). PR in the PTFEV group was absent in five patients at 24 hours post-surgery. At the study endpoint, PR was absent in six, trivial in one and mild in eight patients in the PTFEV group compared to TAP group, where all 15 patients had severe PR.Conclusion:
The bicuspid polytetrafluoroethylene membrane valves significantly decrease the central venous pressure in the immediate postoperative period, facilitate early extubation and, thus, prevent ventilator-related comorbidities. They achieve a high degree of pulmonary competence and do not increase the right ventricular outflow tract gradient in short-term follow-up.
Full text:
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Index:
LILACS (Americas)
Main subject:
Pulmonary Valve
/
Pulmonary Valve Insufficiency
/
Tetralogy of Fallot
/
Cardiac Surgical Procedures
Type of study:
Controlled clinical trial
Limits:
Humans
/
Infant
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
Cardiology
/
General Surgery
Year:
2021
Type:
Article
Affiliation country:
India
Institution/Affiliation country:
Institute of Medical Education and Research/IN
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