Predictive Value of Echocardiographic Pulmonary Artery Parameters Combined with
Pulmonary Valve Annulus Z Scores in the Selection of Surgical Procedures in Children with TOF
ZHAO Jinghan, CHEN Yulong, ZHANG Chen
Department of Ultrasound Medicine, Xuzhou Children’s Hospital, Xuzhou Jiangsu 221000, China
Abstract：Objective To explore the predictive value of echocardiographic pulmonary artery parameters combined with pulmonary
valve annulus Z scores in the selection of surgical procedures in children with tetralogy of Fallot (TOF). Methods A total of 237
children underwent radical surgery for TOF treated in our hospital from July 2019 to May 2021 were analyzed retrospectively. All of
them were examined by cardiac ultrasound and their pulmonary artery parameters, including main pulmonary artery diameter (MPAD),
left pulmonary artery diameter (LPAD), right pulmonary artery diameter (RPAD) and pulmonary valve annulus diameter (PVD) were
recorded, and the Z scores of pulmonary valve annulus were calculated. In addition, children were divided into transvalvular patch
group and non-transvalvular patch group according to whether they had cross valve patch or not, and the prognosis of the two groups
was recorded. The pulmonary artery parameters and pulmonary valve annulus Z scores of the two groups were compared, and the
predictive value of cardiac ultrasound pulmonary artery parameters combined with pulmonary valve annulus Z scores for the choice
of operation in children with TOF was analyzed by receiver operating characteristic (ROC) curve. Results Among 237 children
who underwent radical surgery for TOF, 149 underwent transvalvular patch, and the remaining 88 underwent non-transvalvular
patch. A total of 5 cases died during hospitalization, with a mortality rate of 2.11%. The MPAD, LPAD, RPAD, PVD and Z scores
of pulmonary valve annulus in transvalvular patch group were lower than those in non-transvalvular patch group (P<0.05). The
ROC analysis showed that the sensitivity, specificity and area under curve (AUC) of pulmonary artery parameters in predicting the
feasibility of transvalvular patch after radical operation in children with TOF were 75.84%, 70.45% and 0.765 respectively, and the
sensitivity was higher than those predicted alone (P<0.05), and the specificity and AUC were not significant compared with those
predicted alone (P>0.05). The specificity and AUC of ultrasonic pulmonary artery parameters combined with pulmonary valve
annulus Z scores in predicting transvalvular patch in radical operation in children with TOF were 87.92% and 0.881 respectively,
which were higher than those diagnosed alone (P<0.01). The specificity was 69.32%, which had no significant difference from that
of diagnosis alone (P>0.05). Conclusion Both ultrasonic pulmonary artery parameters and pulmonary valve annulus Z scores of
cardiac ultrasound can predict the choice of operation in children with TOF, but their combined predictive effect is higher.
赵静涵，陈玉龙，张琛. 心脏超声肺动脉参数结合肺动脉瓣环Z值对法洛四联症患儿术式选择的预测价值[J]. 中国医疗设备, 2023, 38(1): 145-149.
ZHAO Jinghan, CHEN Yulong, ZHANG Chen. Predictive Value of Echocardiographic Pulmonary Artery Parameters Combined with
Pulmonary Valve Annulus Z Scores in the Selection of Surgical Procedures in Children with TOF. China Medical Devices, 2023, 38(1): 145-149.
