초록접수 현황
| 14F-149 | 구연 발표 |
A Novel Predictive Value for the Transannular Patch in Tetralogy of Fallot
Kwang Ho Choi, MD¹, Si Chan Sung, MD¹, Hyungtae Kim,MD¹, Hyoung Doo Lee, MD², Gil Ho Ban, MD², Ji Na Kim, MD²
Department of Thoracic and Cardiovascular Surgery¹, Pediatrics², Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Korea
Background : In Tetralogy of Fallot(TOF), the transannular patch(TAP) for relieving the right ventricular outflow tract obstruction (RVOTO) is dependant on pulmonary valvular annulus size. The Z-value of the PV annulus is the most common predictor to perform TAP. But the Z-value is a complex value which is affected by height, body weight and so on, and accurate Z-value is calculated by delicate information of patients. Therefore, we hypothesize the ratio of pulmonic valve annulus size and aortic valve annulus size (GA ratio) to be a better and easier predictor of TAP instead of the Z-value.
Methods : We retrospectively analyzed one hundred and thirty eight patients (M:F=79:59) who had underwent total correction of TOF between 2007 and 2013. We categorized our patients into two groups (TAP group vs non TAP group). The values of great arteries annulus size were evaluated in each group.
Results : Forty-one patients (29.7%) required TAP. Both of GA ratio and Z-value were smaller in TAP group than those of non-TAP group (0.52 vs 0.68, p<0.0001 and -2.87 vs –0.90, p<0.0001). The frequency of palliative treatment (balloon pulmonary valvuloplasty, shunt, infundibulectomy) showed higher in TAP group (64.9% vs 16.8%, p<0.0001). The frequency of postoperative pulmonary regurgitation over moderate in degree at the last follow up echocardiography also revealed a higher incidence in TAP group (68.3% vs 13.4%, p<0.0001). In the result of ROC analyses, cut-off values of the Z-value and GA ratio were –1.66 (Az value : 0.833) and 0.58 (Az value : 0.842). In our results, both Z-value and GA ratio were reliable diagnostic tool as a predictor of TAP.
Conclusion : Our results suggest that GA ratio can be an useful predictor for TAP instead of Z-value, and it can be applied easily and simply in the clinical practice.
Methods : We retrospectively analyzed one hundred and thirty eight patients (M:F=79:59) who had underwent total correction of TOF between 2007 and 2013. We categorized our patients into two groups (TAP group vs non TAP group). The values of great arteries annulus size were evaluated in each group.
Results : Forty-one patients (29.7%) required TAP. Both of GA ratio and Z-value were smaller in TAP group than those of non-TAP group (0.52 vs 0.68, p<0.0001 and -2.87 vs –0.90, p<0.0001). The frequency of palliative treatment (balloon pulmonary valvuloplasty, shunt, infundibulectomy) showed higher in TAP group (64.9% vs 16.8%, p<0.0001). The frequency of postoperative pulmonary regurgitation over moderate in degree at the last follow up echocardiography also revealed a higher incidence in TAP group (68.3% vs 13.4%, p<0.0001). In the result of ROC analyses, cut-off values of the Z-value and GA ratio were –1.66 (Az value : 0.833) and 0.58 (Az value : 0.842). In our results, both Z-value and GA ratio were reliable diagnostic tool as a predictor of TAP.
Conclusion : Our results suggest that GA ratio can be an useful predictor for TAP instead of Z-value, and it can be applied easily and simply in the clinical practice.
책임저자: Si Chan Sung, MD
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Korea
연락처 : Kwang Ho Choi, Tel: 055-360-2567 , E-mail : dream0312@dreamwiz.com
