Abstract
Objective. Purpose of this study was to examine the influence of early (less than 3 years) versus later (greater than 3 years) age at time for the reconstruction of the right ventricle outflow tract (RVOT).
Material and methods. Since 2009 to 2016 at the Federal Center of Cardiovascular Surgery (Penza) we used different types of homografts in 92 patients for the reconstruction of the right ventricle outflow tract (RVOT). Patients were divided into 2 groups based on their age. The first group included patients less than 3 years (n = 44) and the second group are older than 3 years (n = 48). The median age at the time of surgery was 14.6 ± 4.5 months in the first group and 134.3 ± 15.2 months in the second group.
Results. Clinical follow-up data up to 7 years were obtained for 87 (94.6%) patients. Early postoperative mortality was 2.3% (2 patients). There was not a long-term mortality. Redo open heart procedures were performed in 8 patients but one case of infec¬tive endocarditis was the cause of homograft failure. Freedom of reoperations at 7 years for patients less than 3 years was 100% and for patients older than 3 years 97.6%. Balloon angioplasty of LA branches was required in 15 cases. The rate of the freedom from the endovascular interventions in patients from first group at 3, 5, 7 years was 78.2, 70.2, 35.8% and 81.2, 66.1, 65.8% for patients from 2 groups, respectively (p <0.05). Risk factors from endovascular interventions in the long-term period are initial pathology (OR 1,21; Cl 1.17-1.25, p = 0.02) and younger age of patients (odds ratio (OR) 2.24, confidence interval (Cl) 2.21-2.26, p = 0.03).
Conclusion. Homografts using for the reconstruction of RVOT have good hemodynamic characteristics in terms of follow up to 7 years. Patients who underwent correction of congenital heart diseases less than 3 years old had a higher chance of endovascular procedures on the branches of pulmonary arteries, compared to older group.
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About the authors
- Chernogrivov Aleksey Evgen'evich, MD, DM, Cardiovascular Surgeon, Chief of Department;
- Bofanov Dmitriy Alekseevich, Cardiovascular Surgeon;
- Chernogrivov Igor' Evgen'evich, MD, DM, Cardiovascular Surgeon;
- Suleymanov Shakhriyar Fazailovich, Anesthesiologist-Intensivist;
- Kokashkin Mikhail Viktorovich, Anesthesiologist-Intensivist;
- Rybakova Tat'yana Vladimirovna, Pediatrician; Vostokova Ekaterina Valer'evna, Pediatrician;
- Bazylev Vladlen Vladlenovich, MD, DM, Professor, Chief Physician
