초록접수 현황
| 15F-109 | 구연 발표 |
Adjustable Tricuspid Ring Annuloplasty to Reduce Residual Regurgitation: Technical Advantages and Midterm Results
김경화, 최종범, 김태윤, 김종헌, 구자홍
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeollabuk-do, Republic of Korea
Background : Adjustable tricuspid ring annuloplasty consists of an adjustable annular plication for reliable leaflet coaptation and placement of a proper-size rigid ring. The purpose of this study was to confirm the reliability of the annuloplasty technique for treating severe functional tricuspid regurgitation (TR).
Methods : Between September 2007 and June 2014, 60 patients (male, 40 patients; mean age, 60.5 ± 11.6 years) who had severe functional tricuspid regurgitation (TR) underwent adjustable tricuspid ring annuloplasty to reduce residual regurgitation. Tricuspid regurgitation was corrected by adjustable annuloplasty of DeVega-type using two single-row continuous 5-0 polypropylene sutures and then a proper-size rigid ring was placed using two continuous 3-0 polypropylene sutures. Fifty-four patients (90%) had complete follow-up (mean 50.6 ± 17.2 months). The follow-up transthoracic echocardiography (TTE) was performed at least more than 1 year after discharge from hospital.
Results : There were four hospital deaths (6.7%) without late death. Eight patients (13.3%) required leaflet augmentation to obtain complete leaflet coaptation. In 85% of the patients, no. 28 and no. 30 rings were used. In 54 of 56 survivals, the latest TTE revealed no TR in 22 patients (40.7%), trivial TR in 19 (35.2%), mild TR in 10 (18.5%), moderate TR in 2 (3.7%), and severe TR in 1 patient (1.9%). During the follow-up period, 3 patients (5.6%) with moderate TR had improvement to mild TR and 1 patient (1.9%) with mild TR had aggravation to severe TR. Freedom from residual moderate TR or greater at 5 years was 88.2 ± 7.1%. No case of ring dehiscence occurred.
Conclusion : Adjustable tricuspid ring annuloplasty is suggested to be a durable and efficient procedure for reducing remnant regurgitation after repair of severe functional TR.
Methods : Between September 2007 and June 2014, 60 patients (male, 40 patients; mean age, 60.5 ± 11.6 years) who had severe functional tricuspid regurgitation (TR) underwent adjustable tricuspid ring annuloplasty to reduce residual regurgitation. Tricuspid regurgitation was corrected by adjustable annuloplasty of DeVega-type using two single-row continuous 5-0 polypropylene sutures and then a proper-size rigid ring was placed using two continuous 3-0 polypropylene sutures. Fifty-four patients (90%) had complete follow-up (mean 50.6 ± 17.2 months). The follow-up transthoracic echocardiography (TTE) was performed at least more than 1 year after discharge from hospital.
Results : There were four hospital deaths (6.7%) without late death. Eight patients (13.3%) required leaflet augmentation to obtain complete leaflet coaptation. In 85% of the patients, no. 28 and no. 30 rings were used. In 54 of 56 survivals, the latest TTE revealed no TR in 22 patients (40.7%), trivial TR in 19 (35.2%), mild TR in 10 (18.5%), moderate TR in 2 (3.7%), and severe TR in 1 patient (1.9%). During the follow-up period, 3 patients (5.6%) with moderate TR had improvement to mild TR and 1 patient (1.9%) with mild TR had aggravation to severe TR. Freedom from residual moderate TR or greater at 5 years was 88.2 ± 7.1%. No case of ring dehiscence occurred.
Conclusion : Adjustable tricuspid ring annuloplasty is suggested to be a durable and efficient procedure for reducing remnant regurgitation after repair of severe functional TR.
책임저자: 최종범
Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeollabuk-do, Republic of Korea
연락처 : 김경화, Tel: 063-250-1480 , E-mail : tcskim@jbnu.ac.kr
