Application of the ratio of pulmonary valve ring to aortic valve ring to predict the need of transannular patch in the radical operation of tetralogy of Fallot / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio),and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF).Methods A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected,and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis.Results Among the 355 patients,156 children (43.9％) required a transannular patch,and 199 patients (56.1％)did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45 ±0.12 vs.0.54 ±0.15,(-1.75 ±0.98) scores vs.(-0.86 ± 1.39) scores],and the differences were statistically significant (t =5.29,6.32,all P ＜ 0.01).Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of-2 for the children received transannular patch,the area under the curve (AUC) was 0.702 (95％ CI0.64-0.76),sensitivity was 69％,and specificity was 83％;in the case of the GA ratio of 0.58 for the children received transannular patch,the AUC was 0.712 (95％ CI0.66-0.77),sensitivity was 70％,and specificity was 87％.Conclusions The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice.