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Eur J Pediatr Surg 2022; 32(01): 050-055
DOI: 10.1055/s-0041-1739421
Original Article

Experience in the Treatment of Pentalogy of Cantrell with Artificial Materials in a Single Clinical Center

Gang Wang‡   *
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Linyun Xi‡   *
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Hongbo Li
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Yi Wang
2   Pediatric Intensive Care Unit, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Chun Wu
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Zhengxia Pan
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Yonggang Li
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Quan Wang
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
,
Jiangtao Dai 
1   Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
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Abstract

Objective To summarize experience in the treatment of pentalogy of Cantrell (POC) in our hospital and explore the effect of artificial materials in repairing sternal defects.

Materials and Methods A retrospective analysis was performed on treatment of five children with POC treated by using the Gore-Tex patch and titanium mesh in the Department of Cardio-Thoracic Surgery, Children's Hospital of Chongqing Medical University, from January 2010 to January 2019.

Results The concurrent conditions included double outlet of right ventricle (n = 2), ventricular septal defect (VSD) and atrial septal defect (ASD) (n = 1), VSD and ASD and patent ductus arteriosus (n = 1), and VSD and left ventricular diverticulum (n = 1) in five cases with POC. Color Doppler echocardiography and computed tomography (CT) + three-dimensional (3D) reconstruction of the thorax and abdomen were performed preoperatively. The cardiac malformation was corrected according to color Doppler echocardiography, and a Gore-Tex patch was used to repair the pericardial defect. Titanium mesh was made according to CT 3D reconstruction with a 3D printing mold to repair sternal defects. All patients underwent a one-stage operation, all hearts were eventually repositioned, no deaths occurred after the operation, and follow-up was performed for 6 months to 2 years. The patients recovered well, and the exterior thorax was normal.

Conclusion The diagnosis of POC is not difficult. The priority of surgical treatment for POC is to obtain satisfactory corrections of cardiac malformation. The repair of the pericardial defect with the Gore-Tex patch and the sternal defect with the titanium mesh can make the heart return to the mediastinum, reduce the pressure on the heart, reduce the surgical trauma, reduce the difficulty of repairing the sternal defect, and optimally restore the exterior thorax.

Keywords

pentalogy of Cantrell - heart malformation - treatment - artificial materials

* Gang Wang and Linyun Xi contributed equally and hold the first authorship.




Publikationsverlauf

Eingereicht: 08. April 2021

Angenommen: 01. Oktober 2021

Artikel online veröffentlicht:
25. November 2021

© 2021. Thieme. All rights reserved.

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