초록접수 현황
| 14F-077 | 포럼 발표 |
Surgical Management of Pulmonary Atresia with Ventricular Septal Defect : Short Term and Long Term Outcomes
Suk Ho Sohn¹, Sungkyu Cho¹, Eun Seok Choi¹, Woong-Han Kim¹
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, South Korea¹
Background : We analyzed surgical outcomes for the patient of pulmonary atresia with ventricular septal defect and compared short term and long term outcomes of early total correction to those of staged repair.
Methods : From January 2006 to August 2014, all the patients who underwent operations by a single surgeon in a single institution for pulmonary atresia with ventricular septal defect were included. Patients who simultaneously had major aortopulmonary collateral arteries or who were planned for single ventricular repair were excluded. Total 35 patients were collected; 12 patients underwent early total correction (group A), and 23 patients underwent Blalock-Taussig shunt operation followed by total correction (group B).
Results : Mean age at operation was 52.4±59.4 days (58.3±90.8 vs 49.3±36.0, p=0.420) and mean body weight at operation was 3.55±1.17 kg (3.94±1.74 vs 3.35±0.70, p=0.745). Mean follow-up duration after total correction was 45.9±28.3 months (45.0±31.2 vs 46.5±27.3, p=0.912). In group A, there was one operative mortality (8.3%). Two patients underwent palliative right ventricular outflow tract widening first and total correction later. In group B, there were three operative mortalities (13.0%) and one interstage mortality (4.3%). Eighteen patients underwent staged total correction at mean age of 12.2±5.7 months. In both groups, some patients underwent reinterventions or reoperations for branch pulmonary artery stenosis or conduit stenosis. Three year freedom from reintervention rate was 80.7±7.8% (90.0±9.5% vs 75.9±10.6%, p=0.317). Three year freedom from reoperation rate was 81.9±8.4% (90.0±9.5% vs 76.6±12.1%, p=0.084). Three year freedom from reintervention or reoperation rate was 63.1±10.1% (80.0±12.6% vs 53.7±13.3%, p=0.062).
Conclusion : Results of the operations for pulmonary atresia with ventricular septal defect might be acceptable in overall mortality and reintervention/reoperation rate. Early total correction for well selected patients could promise good prognosis in terms of reintervention and reoperation.
Methods : From January 2006 to August 2014, all the patients who underwent operations by a single surgeon in a single institution for pulmonary atresia with ventricular septal defect were included. Patients who simultaneously had major aortopulmonary collateral arteries or who were planned for single ventricular repair were excluded. Total 35 patients were collected; 12 patients underwent early total correction (group A), and 23 patients underwent Blalock-Taussig shunt operation followed by total correction (group B).
Results : Mean age at operation was 52.4±59.4 days (58.3±90.8 vs 49.3±36.0, p=0.420) and mean body weight at operation was 3.55±1.17 kg (3.94±1.74 vs 3.35±0.70, p=0.745). Mean follow-up duration after total correction was 45.9±28.3 months (45.0±31.2 vs 46.5±27.3, p=0.912). In group A, there was one operative mortality (8.3%). Two patients underwent palliative right ventricular outflow tract widening first and total correction later. In group B, there were three operative mortalities (13.0%) and one interstage mortality (4.3%). Eighteen patients underwent staged total correction at mean age of 12.2±5.7 months. In both groups, some patients underwent reinterventions or reoperations for branch pulmonary artery stenosis or conduit stenosis. Three year freedom from reintervention rate was 80.7±7.8% (90.0±9.5% vs 75.9±10.6%, p=0.317). Three year freedom from reoperation rate was 81.9±8.4% (90.0±9.5% vs 76.6±12.1%, p=0.084). Three year freedom from reintervention or reoperation rate was 63.1±10.1% (80.0±12.6% vs 53.7±13.3%, p=0.062).
Conclusion : Results of the operations for pulmonary atresia with ventricular septal defect might be acceptable in overall mortality and reintervention/reoperation rate. Early total correction for well selected patients could promise good prognosis in terms of reintervention and reoperation.
책임저자: 김웅한
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 손석호, Tel: 02-2072-2348 , E-mail : xsshssx@gmail.com
