초록접수 현황
| 14F-014 | 구연 발표 |
Mid-term Results of Mitral Valve Repair with Annuloplasty Strip for Infective Endocarditis
양현숙¹, 이지성², 김준석²,신제균², 지현근²
건국대학교 의학전문대학원 내과학교실¹, 건국대학교 의학전문대학원 흉부외과학교실²
Background : We sought to analyze the mid-term outcomes of the individualized repair approach in patients with infective endocarditis (IE) using a lifting annuloplasty strip.
Methods : Between 2007 and 2014, 27 consecutive patients with an acute or subacute single mitral valve IE (age 43±16 years; range 22-81; 11 men) underwent the mitral annuloplasty with a strip (Mitra-Lift strip, 28-34mm) via right thoracotomy (74%) or median sternotomy (26%). Repair was performed by removal of vegetation, and resection of infected tissue; defect was repaired using a bovine pericardial patch (81%); new chordae formation (19%). Nine (33%) had posterior leaflet augmentation (PLA) to get sufficient coaptation height
Results : Among the 27 patients, 12 (44%) patients presented with a systemic embolism (cerebral in 9); 26 with a significant regurgitation, and 1 with persistent bacteremia. Blood culture was positive in 70%. Underlying valvular pathology was rheumatic in 4 (15%), and previously repaired valve in 1 (3.7%)—re-do repair was performed. Postoperative echocardiograms revealed decreases of LV end-diastolic dimensions (57.2±6.3 versus, 45.4±6.2, or 44.8±4.1mm, p<0.01). The LV ejection fraction decreased immediately, but recovered (64.4±9.6% vs. 54.5±9.8%, or 65.2± 6.1%, p=0.002, p=1.000, respectively). The follow-up echocardiogram (30±22months) showed, no or minimal regurgitation, with a valve opening area of 2.27±0.48cm2. During the clinical follow-up (median, 54.1 months), one (3.7%) mortality was observed (in-hospital, due to pneumonia). There was no reoperation or major cardiovascular event. The five year survival rate was 96.3±0.04%.
Conclusion : The repair technique annuloplasty strip in patients with IE achieved good structural and functional mid-term results.
Methods : Between 2007 and 2014, 27 consecutive patients with an acute or subacute single mitral valve IE (age 43±16 years; range 22-81; 11 men) underwent the mitral annuloplasty with a strip (Mitra-Lift strip, 28-34mm) via right thoracotomy (74%) or median sternotomy (26%). Repair was performed by removal of vegetation, and resection of infected tissue; defect was repaired using a bovine pericardial patch (81%); new chordae formation (19%). Nine (33%) had posterior leaflet augmentation (PLA) to get sufficient coaptation height
Results : Among the 27 patients, 12 (44%) patients presented with a systemic embolism (cerebral in 9); 26 with a significant regurgitation, and 1 with persistent bacteremia. Blood culture was positive in 70%. Underlying valvular pathology was rheumatic in 4 (15%), and previously repaired valve in 1 (3.7%)—re-do repair was performed. Postoperative echocardiograms revealed decreases of LV end-diastolic dimensions (57.2±6.3 versus, 45.4±6.2, or 44.8±4.1mm, p<0.01). The LV ejection fraction decreased immediately, but recovered (64.4±9.6% vs. 54.5±9.8%, or 65.2± 6.1%, p=0.002, p=1.000, respectively). The follow-up echocardiogram (30±22months) showed, no or minimal regurgitation, with a valve opening area of 2.27±0.48cm2. During the clinical follow-up (median, 54.1 months), one (3.7%) mortality was observed (in-hospital, due to pneumonia). There was no reoperation or major cardiovascular event. The five year survival rate was 96.3±0.04%.
Conclusion : The repair technique annuloplasty strip in patients with IE achieved good structural and functional mid-term results.
책임저자: 지현근
건국대학교 의학전문대학원 흉부외과학교실
연락처 : 양현숙, Tel: 02-2030-7591 , E-mail : yang.hyun@gmail.com
