초록접수 현황
| 14F-233 | 구연 발표 |
Outcome of Left Side Heart Valve Replacement in Children: A 20-Year Experience
신홍주, 신유림, 박영환, 박한기
연세대학교 의과대학 심장혈관병원 심장혈관외과학교실
Background : We investigated our 20-year experience with pediatric aortic, mitral valve replacement (AVR, MVR) with respect to mortality, valve-related morbidity, and reoperation risk factors.
Methods : The medical records of 40 patients (18 male, 45%) who underwent 61 left side valve replacements between March 1992 and September 2013 were reviewed, retrospectively.
Median age of the patients was 10.8 years (range, 1.7 months to 17.6 years) and 15 patients (24.6%) were less than 5 years. Congenital valve disease was the most common diagnosis (n = 20, 32.8%). AVR and MVR were performed in 15 and 46 patients, respectively. Double valve replacements were performed in two patients. Mechanical valve was used in 51 cases (83.6%). The median valve size was 23 mm (range, 16 to 33 mm), and the median follow-up duration after valve replacement was 5.4 years (range, 15 days to 21.7 years). Events were defined as the following: thrombosis, embolism, bleeding, reoperation, and death.
Results : There were three in-hospital mortality (all low cardiac outputs) and two late deaths (sepsis after heart transplantation and heart failure at 5.4 and 14.0 years postoperatively, respectively). Survival rates were 95.1%, 95.1%, and 91.9%, at 3, 5, and 10 years, respectively. Freedom from thromboembolism or bleeding events was 94.3%, 94.3%, and 92.9%, at 3, 5 and 10years, respectively. Twenty two reoperations were performed postoperatively. Freedom from reoperation was 91.2 %, 82.6%, and 65.3%, at 3, 5, and 10years, respectively.
Conclusion : Left side valve replacement can be performed in children with favorable early and long-term survival. Thromboembolism or bleeding events due to anticoagulation therapy were not common.
Methods : The medical records of 40 patients (18 male, 45%) who underwent 61 left side valve replacements between March 1992 and September 2013 were reviewed, retrospectively.
Median age of the patients was 10.8 years (range, 1.7 months to 17.6 years) and 15 patients (24.6%) were less than 5 years. Congenital valve disease was the most common diagnosis (n = 20, 32.8%). AVR and MVR were performed in 15 and 46 patients, respectively. Double valve replacements were performed in two patients. Mechanical valve was used in 51 cases (83.6%). The median valve size was 23 mm (range, 16 to 33 mm), and the median follow-up duration after valve replacement was 5.4 years (range, 15 days to 21.7 years). Events were defined as the following: thrombosis, embolism, bleeding, reoperation, and death.
Results : There were three in-hospital mortality (all low cardiac outputs) and two late deaths (sepsis after heart transplantation and heart failure at 5.4 and 14.0 years postoperatively, respectively). Survival rates were 95.1%, 95.1%, and 91.9%, at 3, 5, and 10 years, respectively. Freedom from thromboembolism or bleeding events was 94.3%, 94.3%, and 92.9%, at 3, 5 and 10years, respectively. Twenty two reoperations were performed postoperatively. Freedom from reoperation was 91.2 %, 82.6%, and 65.3%, at 3, 5, and 10years, respectively.
Conclusion : Left side valve replacement can be performed in children with favorable early and long-term survival. Thromboembolism or bleeding events due to anticoagulation therapy were not common.
책임저자: 박한기
연세대학교 의과대학 심장혈관병원 심장혈관외과학교실
연락처 : 신홍주, Tel: 02-2228-8497 , E-mail : medishin@yuhs.ac
