초록접수 현황
| 14F-031 | 구연 발표 |
승모판막치환술 후 조기 및 만기 판막주위누출 발생에 관한 20년 추적관찰 연구
황호영¹, 최재웅¹, 김형관², 김경환¹, 김기봉¹, 안혁¹
서울대학교 의과대학 서울대학교병원 흉부외과학교실¹, 서울대학교병원 내과학교실²
목적 : Data demonstrating long-term occurrence of mitral paravalvular leak (PVL) after mitral valve replacement (MVR) are scarce. We evaluated the incidence of early PVL after MVR and occurrence of late PVL during more than 20 years of follow-up.
방법 : 1202 patients (50.412.2 years, male:female=456:746) who underwent MVR between 1992 and 2008 were studied. Patients underwent first time (n=872), redo- (n=322), or second redo-MVR (n=8). 684 patients underwent concomitant procedures. Follow-up duration was 134 (range, 1-272) months.
결과 : In-hospital mortality rate was 4.5% (54 of 1202). Early PVL was found in 16 patients (1.3%) including 4 patients with major PVL. During follow-up, late PVL without obvious infection occurred in 75 patients (major PVL in 55). Median interval between index operation and major PVL was 136 (range, 6-250) months. Among 55 patients with major PVL, 50 patients underwent reoperations and 5 patients were treated medically. Ten- and 20-year late PVL-free rates were 96.2% and 86.9%, respectively. Ten- and 20-year major PVL-free rates were 98.0% and 89.3%, respectively. Cox proportional hazard analysis revealed that age (hazard ratio [95% confidence interval]=1.05 [1.023-1.08]), male sex (2.70 [1.57-4.66]), redo-MVR (5.57 [3.15-9.85]) and prosthetic valve in aortic position (1.98 [1.16-3.38]) were associated with occurrence of major PVL during follow-up.
결론 : Major PVL without obvious infection occurs even 20 years after MVR with 10- and 20-year major PVL-free rates of 98.0% and 89.3%, respectively. Occurrence of major PVL after MVR is more frequent in elderly, male patients who undergo redo-MVR and concomitant aortic valve replacement.
방법 : 1202 patients (50.412.2 years, male:female=456:746) who underwent MVR between 1992 and 2008 were studied. Patients underwent first time (n=872), redo- (n=322), or second redo-MVR (n=8). 684 patients underwent concomitant procedures. Follow-up duration was 134 (range, 1-272) months.
결과 : In-hospital mortality rate was 4.5% (54 of 1202). Early PVL was found in 16 patients (1.3%) including 4 patients with major PVL. During follow-up, late PVL without obvious infection occurred in 75 patients (major PVL in 55). Median interval between index operation and major PVL was 136 (range, 6-250) months. Among 55 patients with major PVL, 50 patients underwent reoperations and 5 patients were treated medically. Ten- and 20-year late PVL-free rates were 96.2% and 86.9%, respectively. Ten- and 20-year major PVL-free rates were 98.0% and 89.3%, respectively. Cox proportional hazard analysis revealed that age (hazard ratio [95% confidence interval]=1.05 [1.023-1.08]), male sex (2.70 [1.57-4.66]), redo-MVR (5.57 [3.15-9.85]) and prosthetic valve in aortic position (1.98 [1.16-3.38]) were associated with occurrence of major PVL during follow-up.
결론 : Major PVL without obvious infection occurs even 20 years after MVR with 10- and 20-year major PVL-free rates of 98.0% and 89.3%, respectively. Occurrence of major PVL after MVR is more frequent in elderly, male patients who undergo redo-MVR and concomitant aortic valve replacement.
책임저자: 안혁
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 황호영, Tel: 02-2072-3897 , E-mail : scalpel@hanmail.net
