초록접수 현황
| 15F-121 | 구연 발표 |
One-stage Repair for Transposition of Great Arteries or Taussig Bing Anomalies which Associated with Aortic Arch Obstruction
심만식¹, 전창석¹, 양지혁¹, 전태국¹, 강이석², 허준², 송진영²
성균관대학교 의과대학 삼성서울병원 흉부외과학교실¹, 성균관대학교 의과대학 삼성서울병원 소아청소년과학교실²
Background : One-stage arterial switch operation(ASO) with aortic arch obstruction repair is a currently accepted approach, but remains a surgical challenge. This study reports our institutional experience.
Methods : Between January 1995 and June 2015, 16 of 144 ASO patients underwent aortic arch repair concomitantly. There were 6 in transposition of great arteries and 10 in Taussig-Bing anomaly. Aortic arch obstruction included 1 isolated CoA, 9 distal arch hypoplasia with CoA, 4 diffuse arch hypoplasia with CoA and 2 interrupted aortic arch. Ventricular septal defect was present in 15(93.8%) patients. Median age and body weight at operation were 8.5(6-47) days and 3.5(3.1-4.3) kg, respectively.
Results : There was no hospital mortality and no patients required extracorporeal membrane oxygenator support. Early reoperation was performed in 4 patients for wound repair in 2, bleeding control in 1, and lung abscess in 1. Follow-up was available for 13 hospital survivors at a median of 4.9(0.2-11.7) years. Median length of hospital stay was 17.5(8-42) days. There was 1 late death. Six patients required reoperation of which primary procedures were 3 peripheral pulmonary angioplasty, 2 transannular right ventricular outflow tract patch, and 1 aortic valve repair. One patients required balloon angioplasty for recoarctation. Freedom from late reintervention rates were 78.6±1.1 at 1 year and 49.9±1.5 at 3 year, respectively.
Conclusion : One-stage ASO with aortic arch obstruction repair can be performed safely with a good early outcome. Although late reintervention rate is still high, one-stage repair shows good late survival rate and low recoarctation rate.
Methods : Between January 1995 and June 2015, 16 of 144 ASO patients underwent aortic arch repair concomitantly. There were 6 in transposition of great arteries and 10 in Taussig-Bing anomaly. Aortic arch obstruction included 1 isolated CoA, 9 distal arch hypoplasia with CoA, 4 diffuse arch hypoplasia with CoA and 2 interrupted aortic arch. Ventricular septal defect was present in 15(93.8%) patients. Median age and body weight at operation were 8.5(6-47) days and 3.5(3.1-4.3) kg, respectively.
Results : There was no hospital mortality and no patients required extracorporeal membrane oxygenator support. Early reoperation was performed in 4 patients for wound repair in 2, bleeding control in 1, and lung abscess in 1. Follow-up was available for 13 hospital survivors at a median of 4.9(0.2-11.7) years. Median length of hospital stay was 17.5(8-42) days. There was 1 late death. Six patients required reoperation of which primary procedures were 3 peripheral pulmonary angioplasty, 2 transannular right ventricular outflow tract patch, and 1 aortic valve repair. One patients required balloon angioplasty for recoarctation. Freedom from late reintervention rates were 78.6±1.1 at 1 year and 49.9±1.5 at 3 year, respectively.
Conclusion : One-stage ASO with aortic arch obstruction repair can be performed safely with a good early outcome. Although late reintervention rate is still high, one-stage repair shows good late survival rate and low recoarctation rate.
책임저자: 양지혁
성균관대학교 의과대학 삼성서울병원 흉부외과학교실
연락처 : 심만식, Tel: 010-9105-7749 , E-mail : mdshmsh@naver.com
