초록접수 현황
| 14F-202 | 구연 발표 |
The Outcome of Early Surgical Repair of Ventricular Septal Defect in Symptomatic Neonates
Yu Rim Shin, Hong Ju Shin, Young-Hwan Park, Han Ki Park
Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Background : Despite the low perioperative morbidity and mortality rate of patients undergoing repair of isolated ventricular septal defect (VSD), the risk had not been fully established in neonates. This study is1 to evaluate the outcomes of patients who had surgical repair of VSD in neonatal period with evident symptoms of congestive heart failure.
Methods : Between June 2005 and June 2014, 63 neonates underwent surgical repair of isolated VSD or double outlet right ventricle without pulmonary stenosis. The median age was 21 days (range, 9 to 29 days) and the median body weight was 3.4 kg (range, 2.2 to 4.6 kg). The medical records were retrospectively reviewed.
Results : All of the patients had symptoms of congestive heart failure and pulmonary overflow. Ten (15.8 %) patients had chromosomal anomaly. There were seven (12.7 %) patients who needed right ventriculotomy, but it was no longer performed since 2010. There were two hospital deaths (CATCH-22 syndrome with severe sepsis; sudden cardiac arrest caused by ventricular fibrillation). Eight patients had been intubated more than 7 days after the operation, and five of them had genetic anomalies. The median time from the operation to extubation was 4 days (range, 1 to 47 days). The median intensive care unit stay was 6 days (range, 2 to 52 days), and median hospital stay was 13 days (range, 7 to 147 days).
Conclusion : The early surgical repair of isolated VSD in symptomatic neonates can be performed safely with acceptable postoperative course. Special care should be taken in the patients with genetic anomalies.
Methods : Between June 2005 and June 2014, 63 neonates underwent surgical repair of isolated VSD or double outlet right ventricle without pulmonary stenosis. The median age was 21 days (range, 9 to 29 days) and the median body weight was 3.4 kg (range, 2.2 to 4.6 kg). The medical records were retrospectively reviewed.
Results : All of the patients had symptoms of congestive heart failure and pulmonary overflow. Ten (15.8 %) patients had chromosomal anomaly. There were seven (12.7 %) patients who needed right ventriculotomy, but it was no longer performed since 2010. There were two hospital deaths (CATCH-22 syndrome with severe sepsis; sudden cardiac arrest caused by ventricular fibrillation). Eight patients had been intubated more than 7 days after the operation, and five of them had genetic anomalies. The median time from the operation to extubation was 4 days (range, 1 to 47 days). The median intensive care unit stay was 6 days (range, 2 to 52 days), and median hospital stay was 13 days (range, 7 to 147 days).
Conclusion : The early surgical repair of isolated VSD in symptomatic neonates can be performed safely with acceptable postoperative course. Special care should be taken in the patients with genetic anomalies.
책임저자: 박한기
연세대학교 의과대학 심장혈관병원 심장혈관외과학교실
연락처 : 신유림, Tel: 02-2228-8480 , E-mail : yull0629@yuhs.ac
