Application of the ratio of pulmonary valve ring to aortic valve ring to predict the need of transannular patch in the radical operation of tetralogy of Fallot

Q4 Medicine 中华实用儿科临床杂志 Pub Date : 2020-01-05 DOI:10.3760/CMA.J.ISSN.2095-428X.2020.01.007

Zhenyu Lyu, M. Jin, Yan Gu, Yan-yan Xiao, Yifei Yang

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Abstract

Objective To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio), and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF). Methods A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected, and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis. Results Among the 355 patients, 156 children (43.9%) required a transannular patch, and 199 patients (56.1%) did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45±0.12 vs. 0.54±0.15, (-1.75±0.98) scores vs.(-0.86±1.39) scores], and the differences were statistically significant (t=5.29, 6.32, all P<0.01). Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of -2 for the children received transannular patch, the area under the curve (AUC) was 0.702 (95%CI: 0.64-0.76), sensitivity was 69%, and specificity was 83%; in the case of the GA ratio of 0.58 for the children received transannular patch, the AUC was 0.712 (95%CI: 0.66-0.77), sensitivity was 70%, and specificity was 87%. Conclusions The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice. Key words: Tetralogy of Fallot; Transannular patch; Z-score of pulmonary artery

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应用肺动脉瓣环与主动脉瓣环比值预测法洛四联症根治术中经环补片的必要性

目的分析肺动脉瓣环与主动脉瓣环的比值（GA比值），探讨GA比值在预测儿童法洛四联症（TOF）根治性手术中是否需要经环补片方面的应用价值。方法对2016年1月至2017年12月在首都医科大学附属北京安贞医院儿科心脏中心接受根治性手术的355例TOF患儿（男182例，女173例）进行回顾性分析，分为经环补片组和非经环补剂组。收集两组肺动脉瓣环和主动脉瓣环的数值，分别计算肺动脉Z评分和GA比值进行统计学分析。结果355例患者中，156名儿童（43.9%）需要经环补片，199名患者（56.1%）未接受经环补剂。经环补片组的GA比率和肺动脉Z评分低于非经环补剂组[0.45±0.12 vs.0.54±0.15、（-1.75±0.98）vs.（-0.86±1.39）分]，受试者操作特征曲线分析显示，儿童经环补片肺动脉Z评分为-2时，曲线下面积（AUC）为0.702（95%CI:0.64-0.76），敏感性为69%，特异性为83%；在接受经环补片的儿童GA比率为0.58的情况下，AUC为0.712（95%CI:0.66至0.77），敏感性为70%，特异性为87%。结论GA比值是TOF根治术中经环补片的一个简单有效的预测指标，可在临床应用中推广应用。关键词：法洛四联症；跨环贴剂；肺动脉Z评分

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来源期刊

中华实用儿科临床杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

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0.00%

发文量

14243

期刊介绍： Chinese Journal of Applied Clinical Pediatrics ( semi-monthly ) is a core journal of paediatrics under the supervision of China Association for Science and Technology, sponsored by Chinese Medical Association and undertaken by Xinxiang Medical College. Founded in 1986, it is openly circulated both at home and abroad. The journal has several columns, such as Expert Forum, Experimental Research and Paediatric Surgery, which are mainly for paediatric medical workers and medical researchers in hospitals. Its purpose is to reflect the new theories and technologies in paediatric medicine and scientific research at home and abroad, and to promote academic exchanges. Chinese Journal of Applied Clinical Pediatrics is a source journal of China Science Citation Database (CSCD), a core journal of Peking University, a source journal of Chinese science and technology paper statistics (China Science and Technology Core Journals), a core academic journal of RCCSE, a high-quality scientific and technical journal of China, a high-quality scientific and technical journal of China Association for Science and Technology, and a high-quality scientific and technical journal of China Biomedical Science and Technology Association. We have been published in China Biomedical Literature Database (SinoMed), China Knowledge Network, Wanfang Data Knowledge Service Platform, China Academic Journal Abstracts, Scopus Database, Chemical Abstracts (USA), Japan Science and Technology Agency (JSTA) Database, Copernicus Abstracts (Poland), Abstracts of the Centre for Agricultural and Biological Sciences (CABS) of the United Kingdom, Cambridge Scientific Abstracts ProQuest Database, WHO Medical Journal of the Western Pacific Region (WMPR), and WHO Medical Journal of the Western Pacific Region (WMPR) of the United States. We have been included in dozens of authoritative databases at home and abroad, such as WHO Western Pacific Region Index of Medicine (WPRIM), Ullrich's Guide to Periodicals, and so on.