초록접수 현황
| 14F-022 | 구연 발표 |
The Surgical Indications and Results of Mitral Valve Repair in Ventricular Septal Defect Pediatric Patients with Mitral Valve Regurgitation
Woo Sung Jang¹, Woong-Han Kim², Joon Yong Cho¹, Kwangho Choi³, Eun Seok Choi², Young Ok Lee¹, Gun-Jik Kim¹, Jeong Ryul Lee², and Yong Jin Kim⁴
Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea¹,
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, South Korea²,
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Children’s Hospital, Pusan National University College of Medicine, Gyeongnam, South Korea³,
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea⁴
Background : Ventricular septal defect (VSD) can be accompanied by mitral regurgitation (MR) due to chronic volume overload or mitral valve (MV) abnormalities. This study investigated the surgical results of VSD patients with MR.
Methods : One hundred and twelve patients (median age and body weight=4.5 months and 6.2 kg, M:F=48:64) who had VSD with MR between 2002 and 2012 were retrospectively analyzed (group I: MR repair group, group II: no MR repair group). The clinical outcomes of MR according to group were evaluated.
Results : Forty-eight patients (42.9%) required MR repair. Annular dilatation in 46 cases and anterior MV prolapse in 35 cases were representative indications of MR repair. Preoperative z-values of mean diastolic and systolic left ventricle internal diameter were increased in group I (3.4±1.3 and 3.1±1.3) compared to those of group II (2.6±1.7 and 2.3±1.7)(p = 0.02, p = 0.024). The incidence of annular dilatation and MV prolapse were higher in group I (n=46 and n=35) than in group II (n=27 and n=7)(all p<0.001). Posteromedial commissuroplasty was used to repair the MR in 23 patients, and 19 patients underwent posterior annuoplasty to repair the MR. There were no reoperations due to MR during the mean follow-up duration of 4.0±2.9 years. In group I, all patients showed less than grade II MR during the follow-up. All patients showed the same or improved their MR degree in group II.
Conclusion : MR repair in VSD with MR is a feasible and durable procedure with growth potential in pediatric patients.
Methods : One hundred and twelve patients (median age and body weight=4.5 months and 6.2 kg, M:F=48:64) who had VSD with MR between 2002 and 2012 were retrospectively analyzed (group I: MR repair group, group II: no MR repair group). The clinical outcomes of MR according to group were evaluated.
Results : Forty-eight patients (42.9%) required MR repair. Annular dilatation in 46 cases and anterior MV prolapse in 35 cases were representative indications of MR repair. Preoperative z-values of mean diastolic and systolic left ventricle internal diameter were increased in group I (3.4±1.3 and 3.1±1.3) compared to those of group II (2.6±1.7 and 2.3±1.7)(p = 0.02, p = 0.024). The incidence of annular dilatation and MV prolapse were higher in group I (n=46 and n=35) than in group II (n=27 and n=7)(all p<0.001). Posteromedial commissuroplasty was used to repair the MR in 23 patients, and 19 patients underwent posterior annuoplasty to repair the MR. There were no reoperations due to MR during the mean follow-up duration of 4.0±2.9 years. In group I, all patients showed less than grade II MR during the follow-up. All patients showed the same or improved their MR degree in group II.
Conclusion : MR repair in VSD with MR is a feasible and durable procedure with growth potential in pediatric patients.
책임저자: 김웅한
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 장우성, Tel: 053-200-5832 , E-mail : whiteuri@hanmail.net
