ĐÁNH GIÁ KẾT QUẢ SỚM PHẪU THUẬT THAY VAN ĐỘNG MẠCH PHỔI TRẺ EM TẠI BỆNH VIỆN CHỢ RẪY

Abstract

In troduction: Pulmonary valve replacement with a bioprosthetic valve is one of the preferred treatment options for patients with severe pulmonary valve stenosis or regurgitation. This condition is commonly an inevitable consequence or a late complication following complex congenital heart defect repairs, particularly in patients with tetralogy of Fallot, pulmonary atresia with ventricular septal defect, or right ventricular outflow tract lesions. Prolonged pulmonary regurgitation results in right ventricular volume overload, leading to cardiac chamber dilation, right ventricular dysfunction, and an increased risk of life-threatening arrhythmias. Timely valve replacement not only restores normal hemodynamics but also plays a crucial role in improving quality of life and preventing long-term fatal complications in pediatric patients. Objective: The objective of this study was to evaluate the early outcomes of bioprosthetic PVR in pediatric patients managed at Cho Ray Hospital. Methods: This was a retrospective descriptive cross-sectional study conducted on seven patients who underwent bioprosthetic PVR between December 2024 and October 2025 at the Pediatric Cardiac Surgery ICU of Cho Ray Hospital. Clinical data were extracted from medical records. Data cleaning and statistical analyses were performed using SPSS version 22.0. Results: Our study yielded the following reesults: the mean age was 10,7 years. The most common presenting symptom was fatigue: 71,4%, dyspnea: 28,6%. Preoperative echocardiography showed that the majority of patients had pulmonary valve regurgitation: 4 cases (57,1%), with a mean right ventricular diameter of 50,1mm; the pulmonary valve annulus diameter preoperative was 19mm. During surgery, 100% of patients underwent pulmonary valve replacement with a bioprothestic valve. The mean operative time was 375,7 minutes and the mean cardiopulmonary bypass time was 147,1 minutes. Postoperative echocardiography demonstrated good valve function, with no significant stenosis or regurgitation, and improved right ventricular function. Some postoperative complcations were recorded, mainly cardiac arrhythmias requiring treatment. No in- hospital mortality was observed. Conclusion: Bioprosthetic pulmonary valve replacement demonstrated favorable early outcomes in this cohort.