Comparative analysis of different palliative procedures in patients with pulmonary atresia and ventricular septal defect

Voitov A.V.; Omelchenko A.Yu.; Gorbatykh Yu.N.; Arkhipov A.N.; Soynov I.A.; Kulyabin Yu.Yu.; Nichai N.R.; Gorbatykh A.V.; Zubritskiy A.V.; Bogachev-Prokofiev A.V.; Chernyavskiy A.M.

doi:https://doi.org/10.17116/kardio202013061517

Voitov A.V.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3797-4899

Omelchenko A.Yu.

National Medical Research Center

Gorbatykh Yu.N.

National Medical Research Center

ORCID: 0000-0002-6204-538

Arkhipov A.N.

National Medical Research Center

ORCID: 0000-0003-3234-5436

Soynov I.A.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3691-2848

Kulyabin Yu.Yu.

National Medical Research Center

ORCID: 0000-0002-2361-5847

Nichai N.R.

Meshalkin National Medical Research Center

ORCID: 0000-0002-1763-9535

Gorbatykh A.V.

National Medical Research Center

Zubritskiy A.V.

National Medical Research Center

Bogachev-Prokofiev A.V.

Meshalkin National Medical Research Center

SPIN RSCI: 4448-6999
Scopus AuthorID: 55846629000
ResearcherID: L-7881-2014
ORCID: 0000-0003-4625-4631

Chernyavskiy A.M.

National Medical Research Center

Comparative analysis of different palliative procedures in patients with pulmonary atresia and ventricular septal defect

Authors:

Voitov A.V., Omelchenko A.Yu., Gorbatykh Yu.N., Arkhipov A.N., Soynov I.A., Kulyabin Yu.Yu., Nichai N.R., Gorbatykh A.V., Zubritskiy A.V., Bogachev-Prokofiev A.V., Chernyavskiy A.M.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(6): 517‑523

DOI: 10.17116/kardio202013061517

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To cite this article:

Voitov AV, Omelchenko AYu, Gorbatykh YuN, et al. . Comparative analysis of different palliative procedures in patients with pulmonary atresia and ventricular septal defect. Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(6):517‑523. (In Russ.)
https://doi.org/10.17116/kardio202013061517

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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Abstract:

OBJECTIVE

To compare the outcomes of palliative right ventricular outflow tract repair without ventricular septal defect closure by allogeneic vein valved allograft with the modified Blalock-Taussig shunt in the treatment of patients with pulmonary artery atresia and ventricular septal defect.

MATERIAL AND METHODS

A pilot randomized trial enrolled 24 consecutive patients with pulmonary atresia and ventricular septal defect who underwent palliative procedures. Patients were randomized into two groups depending on the type of surgery: right ventricular outflow tract reconstruction without ventricular septal defect closure by allogeneic vein valved allograft (I group, 12 patients) or the modified Blalock-Taussig shunt (II group, 12 patients). Primary endpoint was pulmonary artery growing (index Nakata) in 6 months after palliative surgery. Secondary endpoints were early and mid-term postoperative morbidity, pulmonary artery deformations, redo surgery, mortality, time from palliative surgery to complete repair.

RESULTS

In-hospital mortality was 0% in I group and 9.1% in II group (p=0.452). Pulmonary artery deformation was observed in 5 patients in group I and 4 patients in group II (p=0.076). Oxygen saturation after 6 months was 87.2% (82.1; 92.4) in group I and 76.1% (73; 79.2) in group II (p=0.001). Nakata index in 6 months after palliative sure surgery was 272.1 mm²/m² (244.9; 296.8) in group I and 239.1 mm²/m² (191.8; 274.4) in group II (p=0.035). There was no significant between-group differences in early mortality and complication rate (p=0.063).

CONCLUSION

Palliative right ventricular outflow tract reconstruction without ventricular septal defect closure by allogeneic vein valved allograft ensures better pulmonary artery growth in comparison with the modified Blalock-Taussig shunt (p=0.035) without significant between-group differences in clinical outcomes.

Keywords:

pulmonary atresia

ventricular septal defect

cryopreserved valved venous allograft

pulmonary artery hypoplasia

Authors:

Voitov A.V.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3797-4899

Omelchenko A.Yu.

National Medical Research Center

Gorbatykh Yu.N.

National Medical Research Center

ORCID: 0000-0002-6204-538

Arkhipov A.N.

National Medical Research Center

ORCID: 0000-0003-3234-5436

Soynov I.A.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3691-2848

Kulyabin Yu.Yu.

National Medical Research Center

ORCID: 0000-0002-2361-5847

Nichai N.R.

Meshalkin National Medical Research Center

ORCID: 0000-0002-1763-9535

Gorbatykh A.V.

National Medical Research Center

Zubritskiy A.V.

National Medical Research Center

Bogachev-Prokofiev A.V.

Meshalkin National Medical Research Center

SPIN RSCI: 4448-6999
Scopus AuthorID: 55846629000
ResearcherID: L-7881-2014
ORCID: 0000-0003-4625-4631

Chernyavskiy A.M.

National Medical Research Center

Received:

19.05.2020

Accepted:

25.06.2020

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