초록접수 현황
| 14F-241 | 구연 발표 |
Individual Pulmonary Veins Outgrow Somatic Growth after the Primary Sutureless Repair for Total Anomalous Pulmonary Venous Drainage
방지현¹, 정현진¹, 박천수¹,박정준¹,윤태진¹
¹Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
Background : Indications of sutureless repair (SR) for pulmonary vein anomalies has evolved from post-repair pulmonary vein stenosis after the repair of total anomalous pulmonary venous drainage (TAPVD) to primary SR for TAPVD associated with right atrial isomerism and isolated TAPVD with small IPV and unfavorable pulmonary vein anatomy. We sought to determine the postoperative changes of individual pulmonary veins (IPV) after primary SR.
Methods : Between 2004 and 2013, 21 children underwent primary sutureless repair for TAPVD: 12 with functionally single ventricle, 11 with right atrial isomerism (RAI), 6 with simple TAPVD, and 5 with obstruction. The types of TAPVD were supracardiac in 9, infracardiac in 10, mixed in 2. Utilizing cardiac computed tomography (CT), maximal diameter of each IPV was measure and pulmonary vein index (PVI, summation of cross-sectional areas of all four IPV indexed by body surface area) was calculated.
Results : There were 5 early deaths. Among the early survivors with preoperative cardiac CT, 9 had postoperative cardiac CT at the median interval of 5 months. On postoperative cardiac CT, IPVs were patent in all patients except for one who developed left lower pulmonary vein obstruction. There was 43-71% postoperative increase in actual diameter of all four IPV, and PVI increased significantly from 220 74 to 343 101 mm2/m2 (P-value = 0.028).
Conclusion : IPV outgrow somatic growth after the primary sutureless repair of TAPVD. Primary SR can be a useful measure for patients with TAPVD if IPV and common pulmonary venous channel are small.
Methods : Between 2004 and 2013, 21 children underwent primary sutureless repair for TAPVD: 12 with functionally single ventricle, 11 with right atrial isomerism (RAI), 6 with simple TAPVD, and 5 with obstruction. The types of TAPVD were supracardiac in 9, infracardiac in 10, mixed in 2. Utilizing cardiac computed tomography (CT), maximal diameter of each IPV was measure and pulmonary vein index (PVI, summation of cross-sectional areas of all four IPV indexed by body surface area) was calculated.
Results : There were 5 early deaths. Among the early survivors with preoperative cardiac CT, 9 had postoperative cardiac CT at the median interval of 5 months. On postoperative cardiac CT, IPVs were patent in all patients except for one who developed left lower pulmonary vein obstruction. There was 43-71% postoperative increase in actual diameter of all four IPV, and PVI increased significantly from 220 74 to 343 101 mm2/m2 (P-value = 0.028).
Conclusion : IPV outgrow somatic growth after the primary sutureless repair of TAPVD. Primary SR can be a useful measure for patients with TAPVD if IPV and common pulmonary venous channel are small.
책임저자: 윤태진
서울아산병원
연락처 : 방지현, Tel: 02-3010-1853 , E-mail : mibbi@naver.com
