RESULTS
Seven patients underwent bilateral pulmonary arteries reconstruction, with a median age of 26 months (3 months to 44 months). At the time of admission, the patients had an average oxygen saturation of 72.5% (68%-82%) at rest.
The standard McGoon Index and Nakata Index were 0.86±0.11 (0.7-1) and 117.1±37.5mm2/m2 (68.9-144.5 mm2/m2). If the diameter of the left pulmonary artery at the hilum was included in the calculation formula, the modified McGoon Index and Nakata Index were 1.34±0.15(1.1-1.6) and 149.9±30.9mm2/m2 (99.6-204.4 mm2/m2) respectively. So far, 6 patients have finally achieved TOF repair with bilateral pulmonary artery reconstruction (two-lung repair), and 3 of them underwent one-stage correction.
All patients survived during the postoperative follow-up and showed good cardiac function and normal oxygen saturation >97%, with a mean follow-up time of 2.4±1.4 years (5m–4.5 years). During the follow-up with echocardiograms, it was found that all the left pulmonary arteries that were reconstructed with Goretex vessel had thrombosis, which led to varying degrees of stenosis or even complete occlusion, even though warfarin has been used for anticoagulation therapy. Severe stenosis or even occlusion occurred early after direct anastomosis to reconstruct the left pulmonary artery. The left pulmonary artery reconstructed with the modified anastomosis technique was unobstructed, and the CT image is shown in Figure 3.