A Comparative Analysis Between Two Valed Conduit In The Surgery Treatment Of Pulmonary Atresia With Ventricular Septal Defect

BackgroundPulmonary atresia with ventricular septal defect is a complex congenital heart disease,with an incidence of about 0.07 cases per 1000 live births,accounting for 1%-2% of all congenital heart disease.One of the most important steps in its surgical treatment is the right ventricular-pulmonary artery connection.After years of development,the bonvine jugular vein valve conduit and the expanded polytetrafluoroethylene conduit have become popular choices for surgeons.This study aims to compare the prognosis of two types of conduits in the surgical treatment of pulmonary atresia with ventricular septal defect,to guide clinical practice.MethodsThis study collected data of 141 patients with Pulmonary atresia combined with ventricular septal defect who underwent right ventricular pulmonary artery connection surgery at Guangzhou Women and Children’s Medical Centre from January 2018 to December 2022.The data was sorted and analyzed with t-test,stratified regression,Kaplan-Meier survival analysis and COX regression analysis.ResultsWe collected 59 cases for ePTFE group and 82 cases for BJVC group and analyzed.The average follow-up time was 33.63 months.12 cases of conduit stenosis occurred in the BJVC group,and the incidence was 14.8%.No conduit stenosis was occourred in the ePTFE group.A total of 9 cases of reoperation occourred in the BJVC group,all of which is related to conduit failure,and the reoperation rate was 11.0%.A total of 4cases of reoperation occurred in the ePTFE group,of which 1 case was related to conduit failure,and the reoperation rate was 6.9%.A total of 21 cases of re-intervention occurred in the BJVC group,and the re-intervention rate was 25.6%.And 14 cases occurred in the BJVC group,and the re-intervention rate was 23.7%.There were statistically significant differences between the two groups in terms of conduit stenosis and conduit-related reoperation rates,with P values of 0.001 and 0.031,respectively.The difference between Kaplan-Merier curves for conduit stenosis of two groups was statistically significant,with a P value of 0.03.COX analysis on conduit stenosis occurrence in both groups showed that the Hazard Ratio of stenosis occurrence in ePTFE group was 0.099 times that of BJVC group,with the P value of 0.043.ConclusionsBoth types of conduits are excellent alternative selection and can be selected reasonably according to actual situations.The main stem durability of ePTFE conduit may be better than that of BJV conduit.