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The Follow-up of Bovine Jugular Vein(BJV) to Reconstruct the Rightventricular Outflow Tract: Early and Medium Term Results

Author: ShiLiWei
Tutor: WuZhongShi
School: Central South University
Course: Surgery
Keywords: Bovine jugular vein Right ventricular outflow tract Follow-up Pulmonary valve function
CLC: R726.5
Type: Master's thesis
Year: 2011
Downloads: 3
Quote: 0
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Abstract


Objective: A retrospective analysis was performed using cell binding to photo-oxidation treatment bovine jugular vein (BJV) right ventricular outflow tract reconstruction in patients with postoperative follow-up clinical data early and mid-evaluate cell binding to photo-oxidation treatment BJV clinical results. Materials and Methods: From April 2007 to April 2011 at the Second Xiangya Hospital pediatric cardiac surgery and the Asian Cardiovascular Hospital successfully applied BJV reconstruction of right ventricular outflow tract (n = 29) or limb widen the right ventricular outflow tract (n = 95) of the total of 124 cases of congenital heart disease in this study. Among them, tetralogy of Fallot (TOF) 76 cases of double outlet ventricle with pulmonary stenosis (PS) 26 cases of pulmonary atresia (PA) with ventricular septal defect (VSD) 15 cases of common arterial trunk merge VSD3 cases, transposition of great arteries (TGA) 4 cases; male 75 cases, female 49 cases; mean age was 86.3 ± 26.7 months (May -33 years old), of which 39 cases less than one year old; weight was 17.5 ± 14kg (5-49Kg). Of which 29 cases were used to photo-oxidation treatment cell binding bovine jugular vein valved conduit (BJVC) reconstruction pulmonary - right ventricle connection, the remaining 95 patients were combined using the photo-oxidation process acellular bovine jugular vein (BJV) limb across the valve ring widening right ventricular outflow tract. All patients are a fully restored. Some patients there is a large body of pulmonary collateral vessels, 14 patients taking preoperative interventional closure of collateral, collateral involved in 37 cases of postoperative occlusion, 25 cases of patients undergoing ligation of collateral vessels. Before discharge and follow-up periods are used echocardiography to evaluate the clinical effects, including pulmonary artery diameter, pulmonary transvalvular pressure gradient (PG), valvular activity status, piping and valve calcification and thrombosis, whether anastomotic stricture. All data applications SPSS16.0 statistical software for statistical analysis. Results: The follow-up time for the February -48 months. All patients underwent follow-up. No deaths during follow-up. All cardiac function grade Ⅰ - Ⅱ, without due bovine jugular vein conduit distorted or leaflet calcification, reflux, thrombosis required reoperation. 29 cases using BJVC right ventricular outflow tract reconstruction in patients with early postoperative follow-up period compared to no significant increase in pulmonary artery size (P gt; 0.05); bovine jugular vein valve leaflet calcification, no significant increase reflux; early postoperative MTPG 13.1 ± 4.3mmHg, pulmonary side pressure 20.9 ± 4.5mmHg, right ventricular end pressure 9.9 ± 4.2mmHg, follow-up period MTPG 15.1 ± 4.3mmHg, pulmonary side pressure 23.2 ± 4.5mmHg, right ventricle side pressure 10.3 ± 4.2mmHg, early postoperative follow-up period compared with no significant change (P gt; 0.05). There are two cases of pulmonary artery reconstruction using BJVC - right ventricular outflow tract in patients with pulmonary artery pressure side anastomosis gt; 50mmHg, including 1 patient end anastomosis recent pulmonary pressure gt; 60mmHg, who underwent balloon angioplasty intervention. 95 cases of cross-ring using BJV petals widen the right ventricular outflow tract in patients with bovine jugular vein valve leaflets open and close well, no significant calcification, MTPG no significant change (P gt; 0.05), no significant thrombosis; compared with the early postoperative follow-up period, no significant increase in the degree of pulmonary regurgitation (P gt; 0.05); no significant changes in right ventricular internal diameter (P gt; 0.05); no significant outflow tract obstruction. Conclusion: The combination of light acellular oxidation treatment BJV reconstruction pulmonary artery and right ventricle connection or limb widen the right ventricular outflow tract showed a good clinical outcome as early as mid with good morphological and hemodynamic characteristics, is a more pulmonary ideal alternative materials.

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CLC: > Medicine, health > Pediatrics > Pediatric surgery > Surgery in children of all physiological systems
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