초록접수 현황
| 14F-094 | 포럼 발표 |
Mid-term Results of Vertical Plication Repair of Ebstein’s Anomaly
김지성, 김민석, 조성규, 최은석, 김웅한
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : Ebstein’s anomaly is a rare congenital malformation and has wide disease spectrum, so there are few experiences of repair of Ebstein’s anomaly. We retrospectively reviewed the mid-term outcomes of Ebstein’s anomaly patients who underwent vertical plication repair.
Methods : From October 2004 to March 2014, 12 patients(median age 5.07 years, range 6 months~42 years, male : female = 4 : 7) underwent vertical plication repair of Ebstein’s anomaly by single surgeon. Patients were classified according to Carpentier’s classification (type A : 1, type B : 8, type C : 2, type D : 0). Eight patients presented arrhythmic electrocardiogram (PSVT : 1, Right bundle branch block : 5 patients, atrial flutter : 1, second degree atrioventricular (AV) block : 1). Atrial flutter was treated with right sided maze operation, and permanent pacemaker insertion was done for AV block patient. Only one patient got a one-and-half ventricular repair due to right ventricular dysfunction, and others got biventricular repair. Concomitant other cardiac anomalies (ASD : 10, VSD : 1) were repaired at the same time. Early eight patients were repaired by Carpentier’s technique, whereas late three patients were repaired by Cone reconstruction technique.
Results : There were no early and late mortality, as well as reoperation during follow-up period. Mean duration of follow up was 5.54 ± 3.67 years. Postoperative and last follow-up (mean period 5.22 ± 3.58 years) echocardiography revealed significantly decreased tricuspid regurgitation (TR) grade (preoperative grade = 3.59, postoperative grade = 1.59, last follow-up grade 2.09, both p = 0.003). Also, New York Heart Association (NYHA) functional class had been improved (preoperative class = 1.91, postoperative class = 1.00, p = 0.007).
Conclusion : Vertical plication repair of Ebstein’s anomaly including Carpentier’s technique or Cone reconstruction is favorable surgical treatment with very low mortality and morbidity and good functional improvement of tricuspid regurgitation in mid-term follow-up results.
Methods : From October 2004 to March 2014, 12 patients(median age 5.07 years, range 6 months~42 years, male : female = 4 : 7) underwent vertical plication repair of Ebstein’s anomaly by single surgeon. Patients were classified according to Carpentier’s classification (type A : 1, type B : 8, type C : 2, type D : 0). Eight patients presented arrhythmic electrocardiogram (PSVT : 1, Right bundle branch block : 5 patients, atrial flutter : 1, second degree atrioventricular (AV) block : 1). Atrial flutter was treated with right sided maze operation, and permanent pacemaker insertion was done for AV block patient. Only one patient got a one-and-half ventricular repair due to right ventricular dysfunction, and others got biventricular repair. Concomitant other cardiac anomalies (ASD : 10, VSD : 1) were repaired at the same time. Early eight patients were repaired by Carpentier’s technique, whereas late three patients were repaired by Cone reconstruction technique.
Results : There were no early and late mortality, as well as reoperation during follow-up period. Mean duration of follow up was 5.54 ± 3.67 years. Postoperative and last follow-up (mean period 5.22 ± 3.58 years) echocardiography revealed significantly decreased tricuspid regurgitation (TR) grade (preoperative grade = 3.59, postoperative grade = 1.59, last follow-up grade 2.09, both p = 0.003). Also, New York Heart Association (NYHA) functional class had been improved (preoperative class = 1.91, postoperative class = 1.00, p = 0.007).
Conclusion : Vertical plication repair of Ebstein’s anomaly including Carpentier’s technique or Cone reconstruction is favorable surgical treatment with very low mortality and morbidity and good functional improvement of tricuspid regurgitation in mid-term follow-up results.
책임저자: 김웅한
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 김지성, Tel: 02-2072-2347 , E-mail : ttee03@gmail.com
