초록접수 현황
| 14F-208 | 포럼 발표 |
Mid-term Outcomes of Repair of Coarctation of Aorta with Hypoplastic Arch : End-to-Side Anastomosis Technique
김응래1, 남진혜, 조성규1, 최은석1, 장우성2, 김웅한1
서울대학교병원 어린이병원 흉부외과1, 경북대병원 흉부외과2
Background : Restenosis of repaired coarctation of aorta and hypertension are frequently found after repair of coarctation of aorta (CoA), especially in patients with hypoplastic aortic arch. To solve this problem, we have used end-to-side anastomosis technique in these patients. Thus, we sought to evaluate the mid-term surgical results of it.
Methods : From 2004 to 2011, 53 consecutive patients under the age of 100 days at the time of the repair for CoA with hypoplastic aortic arch were enrolled in this study (mean age: 20.3 days, range 0 to 93 days). Patients with single ventricle physiology were excluded. The repair for CoA was performed under selective cerebral and myocardial perfusion. Follow-up with echocardiography and chest computed tomography(CT) were obtained. Blood pressures were also measured at every out-patient visit. Doppler flow velocity more than 2.5m/s across the repair site was considered “restenosis”.
Results : The median follow-up duration was 5.4 years (range, 0.2 to 10.5 years) and there was no early and late mortality. Isolated aortic coarctation was seen in only 3 patients (5.7 %) and other patients had at least one more cardiac anomalies (n= 50, 94.3 %). Restenosis of repaired aortic arch was observed in 3 patients (5.7 %). Of these 3 patients, 2 patients didn’t needed reintervention and 1 patient underwent reoperation 4 month after the first surgery. Freedom from reintervention or reoperation was 94.3 % at 10 years. There was no risk factor of reintervention or reoperation. Of the 53 patients, only 1 patient required medication for hypertension.
Conclusion : End-to-side anastomosis technique showed excellent mid-term outcomes in patients with hypoplastic aortic arch.
Methods : From 2004 to 2011, 53 consecutive patients under the age of 100 days at the time of the repair for CoA with hypoplastic aortic arch were enrolled in this study (mean age: 20.3 days, range 0 to 93 days). Patients with single ventricle physiology were excluded. The repair for CoA was performed under selective cerebral and myocardial perfusion. Follow-up with echocardiography and chest computed tomography(CT) were obtained. Blood pressures were also measured at every out-patient visit. Doppler flow velocity more than 2.5m/s across the repair site was considered “restenosis”.
Results : The median follow-up duration was 5.4 years (range, 0.2 to 10.5 years) and there was no early and late mortality. Isolated aortic coarctation was seen in only 3 patients (5.7 %) and other patients had at least one more cardiac anomalies (n= 50, 94.3 %). Restenosis of repaired aortic arch was observed in 3 patients (5.7 %). Of these 3 patients, 2 patients didn’t needed reintervention and 1 patient underwent reoperation 4 month after the first surgery. Freedom from reintervention or reoperation was 94.3 % at 10 years. There was no risk factor of reintervention or reoperation. Of the 53 patients, only 1 patient required medication for hypertension.
Conclusion : End-to-side anastomosis technique showed excellent mid-term outcomes in patients with hypoplastic aortic arch.
책임저자: 김웅한
서울대학교병원 어린이병원 흉부외과
연락처 : 김응래, Tel: 02-2072-2348 , E-mail : xion119@naver.com
