Cargando…
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
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 vers...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cirurgia Cardiovascular
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918384/ https://www.ncbi.nlm.nih.gov/pubmed/32759096 http://dx.doi.org/10.21470/1678-9741-2020-0059 |
_version_ | 1783657910340943872 |
---|---|
author | Rawat, Sanjib Jaswal, Vivek Thingnam, Shyam Kumar Singh Singh, Harkant Mahajan, Sachin Kynta, Reuben Lamiaki Puri, Goverdhan Dutt Rohit, Manoj Kumar |
author_facet | Rawat, Sanjib Jaswal, Vivek Thingnam, Shyam Kumar Singh Singh, Harkant Mahajan, Sachin Kynta, Reuben Lamiaki Puri, Goverdhan Dutt Rohit, Manoj Kumar |
author_sort | Rawat, Sanjib |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7918384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
record_format | MEDLINE/PubMed |
spelling | pubmed-79183842021-03-04 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 Rawat, Sanjib Jaswal, Vivek Thingnam, Shyam Kumar Singh Singh, Harkant Mahajan, Sachin Kynta, Reuben Lamiaki Puri, Goverdhan Dutt Rohit, Manoj Kumar Braz J Cardiovasc Surg Original Article 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. Sociedade Brasileira de Cirurgia Cardiovascular 2021 /pmc/articles/PMC7918384/ /pubmed/32759096 http://dx.doi.org/10.21470/1678-9741-2020-0059 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Rawat, Sanjib Jaswal, Vivek Thingnam, Shyam Kumar Singh Singh, Harkant Mahajan, Sachin Kynta, Reuben Lamiaki Puri, Goverdhan Dutt Rohit, Manoj Kumar 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918384/ https://www.ncbi.nlm.nih.gov/pubmed/32759096 http://dx.doi.org/10.21470/1678-9741-2020-0059 |
work_keys_str_mv | AT rawatsanjib shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT jaswalvivek shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT thingnamshyamkumarsingh shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT singhharkant shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT mahajansachin shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT kyntareubenlamiaki shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT purigoverdhandutt shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial AT rohitmanojkumar shorttermoutcomeofpolytetrafluoroethylenemembranevalveversustransannularpericardialpatchreconstructionofrightventricularoutflowtractintetralogyoffallotarandomizedcontrolledtrial |