초록접수 현황
| 14F-144 | 포럼 발표 |
Posteoperative Changes in Right Ventricular Function after Repair of Ebstein's Anomaly
박성준, 박천수, 박정준, 윤태진
울산대학교 의과대학 서울아산병원 흉부외과학교실
Background : Little is known about the postoperative changes in right ventricular (RV) function after the repair of Ebstein’s anomaly, particularly when surgical techniques incorporating the atrialized RV (aRV) into the functional RV are employed. We sought to evaluate the postoperative RV function in patients who underwent surgical correction of Ebstein’s anomaly without the plication of aRV.
Methods : Of the 18 adult patients with Ebstein’s anomaly who underwent TV repair using Hetzer technique between 2002 and 2013, echocardiographic data were available in 14 patients. Median age at operation was 42 years (17-57 years), and concomitant bidirectional Glenn shunt was performed in 12 (12/14, 86%) to constitute a one and a half ventricular physiology. A total of 41 echocardiographic studies were conducted, at immediate postoperative period and during the median follow-up period of 54 months. RV end-diastolic area (RVEDA) and RV end-systolic area (RVESA) were measured on 4-chamber views, and RV fractional area (RVFA) was calculated: RVFA= (RVEDA-RVESA) / RVEDA. Using mixed linear regression, time-related postoperative changes in RVFA were analyzed.
Results : There was no early or late death. Immediate postoperative tricuspid regurgitation (TR) was trivial to mild in 7 patients and moderate in 5, and moderate residual TR on immediate postoperative echocardiography regressed to mild degree during the follow-up in 4 patients. Median RVEDA, RVESA, and RVFA at immediate postoperative period were 20.9 cm2 (10.9 – 41.1 cm2), 15.3 cm2 (9.6 – 36.9 cm2), and 23.7 % (3.5 - 37.9 %), respectively. RVFA was subnormal (<35%) in 11 patients (11/14, 79%), and increased significantly during the follow-up period (P=0.001, Figure 1).
Conclusion : After the repair of tricuspid valve in Ebstein’s anomaly, RV function deteriorates during the immediate postoperative period but improves as time passes.
Methods : Of the 18 adult patients with Ebstein’s anomaly who underwent TV repair using Hetzer technique between 2002 and 2013, echocardiographic data were available in 14 patients. Median age at operation was 42 years (17-57 years), and concomitant bidirectional Glenn shunt was performed in 12 (12/14, 86%) to constitute a one and a half ventricular physiology. A total of 41 echocardiographic studies were conducted, at immediate postoperative period and during the median follow-up period of 54 months. RV end-diastolic area (RVEDA) and RV end-systolic area (RVESA) were measured on 4-chamber views, and RV fractional area (RVFA) was calculated: RVFA= (RVEDA-RVESA) / RVEDA. Using mixed linear regression, time-related postoperative changes in RVFA were analyzed.
Results : There was no early or late death. Immediate postoperative tricuspid regurgitation (TR) was trivial to mild in 7 patients and moderate in 5, and moderate residual TR on immediate postoperative echocardiography regressed to mild degree during the follow-up in 4 patients. Median RVEDA, RVESA, and RVFA at immediate postoperative period were 20.9 cm2 (10.9 – 41.1 cm2), 15.3 cm2 (9.6 – 36.9 cm2), and 23.7 % (3.5 - 37.9 %), respectively. RVFA was subnormal (<35%) in 11 patients (11/14, 79%), and increased significantly during the follow-up period (P=0.001, Figure 1).
Conclusion : After the repair of tricuspid valve in Ebstein’s anomaly, RV function deteriorates during the immediate postoperative period but improves as time passes.
책임저자: 윤태진
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 박성준, Tel: 02-3010-3580 , E-mail : sungjun0919@naver.com
