Abstract: Objective To compare the clinical efficacy between the systemic-to-pulmonary artery shunt surgery and palliative right ventricular to pulmonary artery (RV-PA) connection in patients with pulmonary atresia with ventricular septal defect (PA/VSD). Methods We retrospectively analyzed the clinical data of 49 children with PA/VSD who received palliative surgery in the Pediatric Hospital of Fudan University from January 2001 to June 2021,and compared the perioperative results and therapeutic effect of the two kinds of palliative surgery as well as the postoperative pulmonary vascular development. Results  Median follow-up time was 2.4 (1.2,3.3) years.There were no significant differences in the early postoperative mortality,complication rate,postoperative mechanical ventilation time,CCU retention time or the interval between two operations between the systemic-to-pulmonary shunt group(n=31) and the palliative RV-PA connection group(n=18)(P>0.05).Postoperative percutaneous oxygen saturation,McGoon ratio and Nakata index were increased in both groups compared with those before surgery (P<0.05).Postoperative percutaneous oxygen saturation in the palliative RV-PA connection group was higher than that in the systemic-to-pulmonary shunt group,and the difference was statistically significant(P<0.05) .Conclusion  Both palliative RV-PA connection and systemic-to-pulmonary arterial shunt surgery can promote pulmonary artery development in children with PA/VSD,among which the improvement in postoperative oxygenation is more obvious in the palliative RV-PA connection group.

Key words:

Pulmonary atresia with ventricular septal defect, Systemic-to-pulmonary arterial shunt surgery, Palliative right ventricular to pulmonary artery connection(RV-PA) surgery