초록접수 현황
| 14F-058 | 구연 발표 |
Surgical Results of Mitral Valve Repair for Congenital Mitral Valve Stenosis in Pediatric Patients
Sungkyu Cho, Woong-Han Kim, Eun Seok Choi, Jeong Ryul Lee, Yong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital
Background : Mitral valve repair has been performed congenital mitral valve stenosis in pediatric patients. But congenital mitral valve stenosis is a heterogeneous group of lesion and remained challenge.
Methods : From March, 1999 to October, 2013 mitral valve repair was performed in 20 patients with congenital mitral valve stenosis. The median age was 10.3 month (from 22 days to 9.1 years) and the mean body weight was 7.7±4.1kg at time of operation. Multiple level left-side heart obstruction was present in 9 patients (45%). Severe mitral regurgitation present in one patient.
Results : The main etiology of the mitral stenosis was supravalvular mitral ring in 7 patients, valvular in 5, parachute deformity of papillary muscles in 4 and other abnormal papillary muscles in 5. Mean mitral valve pressure gradient improved from 10.5±4.1 mmHg to 3.5±1.8 mmHg after mitral valve repair (N=16, p<0.0001). Mean follow up duration was 4.6+4.8 years. One patient died postoperatively due to septic shock. Three patients required a second operation (1 for aortic stenosis, 2 for progressed mitral stenosis). Among them, two patients died, one patient due to CPB weaning failure and another patient due to multiple cerebral infarcts. At the last follow-up mean mitral valve pressure gradient was 4.7±3.2mmHg, and moderate or more mitral insufficiency was detected in 3 patients. At 10 years, survival by Kaplan-Meier was 81 ± 10.0 %, and freedom from reoperation was 86.0 ± 10.0%.
Conclusion : The pediatric patients who underwent mitral valve repair for congenital mitral stenosis showed good results. The follow-up echocardiography also revealed satisfactory results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.
Methods : From March, 1999 to October, 2013 mitral valve repair was performed in 20 patients with congenital mitral valve stenosis. The median age was 10.3 month (from 22 days to 9.1 years) and the mean body weight was 7.7±4.1kg at time of operation. Multiple level left-side heart obstruction was present in 9 patients (45%). Severe mitral regurgitation present in one patient.
Results : The main etiology of the mitral stenosis was supravalvular mitral ring in 7 patients, valvular in 5, parachute deformity of papillary muscles in 4 and other abnormal papillary muscles in 5. Mean mitral valve pressure gradient improved from 10.5±4.1 mmHg to 3.5±1.8 mmHg after mitral valve repair (N=16, p<0.0001). Mean follow up duration was 4.6+4.8 years. One patient died postoperatively due to septic shock. Three patients required a second operation (1 for aortic stenosis, 2 for progressed mitral stenosis). Among them, two patients died, one patient due to CPB weaning failure and another patient due to multiple cerebral infarcts. At the last follow-up mean mitral valve pressure gradient was 4.7±3.2mmHg, and moderate or more mitral insufficiency was detected in 3 patients. At 10 years, survival by Kaplan-Meier was 81 ± 10.0 %, and freedom from reoperation was 86.0 ± 10.0%.
Conclusion : The pediatric patients who underwent mitral valve repair for congenital mitral stenosis showed good results. The follow-up echocardiography also revealed satisfactory results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.
책임저자: 김웅한
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 조성규, Tel: 02-2072-2384 , E-mail : csk1022@hanmail.net
