초록접수 현황
| 14F-203 | 구연 발표 |
The Impact of Small Size Aortic Prosthesis on Late Onset Tricuspid Regurgitation in Double Valve Replacement (DVR) Patients
Seung Hyun Lee, Byung-Chul Chang, Kyung-Jong Yu, Young-Nam Youn, Sak Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
Background : The study aim was to evaluate the impact of small size (especially under 21mm size) aortic prosthesis on late onset tricuspid regurgitation in double valve replacement patients (DVR).
Methods : A total of 2392 patients underwent aortic valve replacement (AVR) with or without concomitant valve surgery between January 1990 and May 2014. Of these patients, 752 underwent double valve replacement (with or without concomitant tricuspid annuloplasty). 250 underwent small size aortic valve replacement, whereas 502 received non- small size (20mm<) valve replacement. The composite endpoints of tricuspid regurgitation (grade III or IV) and tricuspid valve surgery (TVP or TVR) were compared in these two groups using the Kaplan-Meier method.
Results : The mean follow up duration was 128±80 months. Overall survival rate was not different between groups (1, 5, and 10 years: 95%, 91%, 84% vs. 97%, 91%, 84%, p=0.30), however small size AVR group were at significantly lower recurrent TR (III≤) free survival rate (1, 5, and 10 years: 98%, 96%, 91% vs. 100%, 99%, 97%, p=0.027). Age (p=0.003), gender (female, p<0.001), aortic (p<0.001) and mitral (p< 0.001) prosthesis size, atrial fibrillation (AF, p<0.001), and aortic position pannus (p<0.001) were risk factors by using Cox Hazard risk analysis.
Conclusion : The study results showed that small size AVR (≤20mm) in DVR might be strong correlated with late progression of TR. From this result, we should consider bigger valve for aortic position as possible and careful echocardiography follow up for prevention of TR progression.
Methods : A total of 2392 patients underwent aortic valve replacement (AVR) with or without concomitant valve surgery between January 1990 and May 2014. Of these patients, 752 underwent double valve replacement (with or without concomitant tricuspid annuloplasty). 250 underwent small size aortic valve replacement, whereas 502 received non- small size (20mm<) valve replacement. The composite endpoints of tricuspid regurgitation (grade III or IV) and tricuspid valve surgery (TVP or TVR) were compared in these two groups using the Kaplan-Meier method.
Results : The mean follow up duration was 128±80 months. Overall survival rate was not different between groups (1, 5, and 10 years: 95%, 91%, 84% vs. 97%, 91%, 84%, p=0.30), however small size AVR group were at significantly lower recurrent TR (III≤) free survival rate (1, 5, and 10 years: 98%, 96%, 91% vs. 100%, 99%, 97%, p=0.027). Age (p=0.003), gender (female, p<0.001), aortic (p<0.001) and mitral (p< 0.001) prosthesis size, atrial fibrillation (AF, p<0.001), and aortic position pannus (p<0.001) were risk factors by using Cox Hazard risk analysis.
Conclusion : The study results showed that small size AVR (≤20mm) in DVR might be strong correlated with late progression of TR. From this result, we should consider bigger valve for aortic position as possible and careful echocardiography follow up for prevention of TR progression.
책임저자: 이삭
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
연락처 : 이승현, Tel: 02-2228-8491 , E-mail : henry75@yuhs.ac
