초록접수 현황
| 15F-136 | 구연 발표 |
Risk Factors for Interstage Mortality after Shunt Procedure in Home Monitored Patients
박원균¹, 방지현¹, 박천수¹, 윤태진¹, 구현우², 백재숙³, 유정진³, 김영휘³, 고재곤³, 박정준¹
울산대학교 의과대학 서울아산병원 흉부외과학교실 소아심장외과¹, 울산대학교 의과대학 서울아산병원 영상의학과학교실², 울산대학교 의과대학 서울아산병원 소아과학교실 소아심장과³
목적 : Some patients have a risk of sudden death while waiting for next operation following a shunt procedure. In our institution, we have been providing patients with a home monitoring program since 2010 in order to prevent such events. This study aims to analyze the risk factors of interstage death in home monitored patients after a shunt procedure
방법 : Between May 2010 and May 2015, 127 patients (M: F=65:62) were to be subject to the home monitoring system after a shunt operation. Patients were classified into two groups: Functional single ventricle (FSV) group (group I) (n=61, 48.0%) and biventricular repair (BVR) group (group II) (n=66, 52.0%). And each group was divided according to whether the patient had absence (subtype a) or stenosis (subtype b) of pulmonary artery.
결과 : Median age and body weight at surgery was 22 days (range, 1 to 280days) and 3.36kg (range, 1.55 to 8.10kg), respectively. Mortality prior to next-stage operation was 12(9.4%) patients (8[8/42, 19.0%] for the group Ia, 1[1/19, 5.3%] for group Ib, 3[3/33, 9.1%] for group IIa, 0[0/33, 0.0%] for group IIb). There were no significant difference of mortality rate between each subtype groups except group Ia versus group IIb (p=0.008). But, mortality of group Ia was especially higher as compared to sum of other groups (n=8 versus n=4, respectively, p=0.022). On a multivariable analysis, there were no statistically significant risk factors of mortality in aspects of preoperative juxtaductal stenosis, body weight, shunt size/body weight ratio, use of cardiopulmonary bypass, sternotomy incision, position of aortic arch and dosage of aspirin
결론 : The risk of interstage death was shown to be significantly higher in patients with FSV with PA, so these patients should be followed more thoroughly.
방법 : Between May 2010 and May 2015, 127 patients (M: F=65:62) were to be subject to the home monitoring system after a shunt operation. Patients were classified into two groups: Functional single ventricle (FSV) group (group I) (n=61, 48.0%) and biventricular repair (BVR) group (group II) (n=66, 52.0%). And each group was divided according to whether the patient had absence (subtype a) or stenosis (subtype b) of pulmonary artery.
결과 : Median age and body weight at surgery was 22 days (range, 1 to 280days) and 3.36kg (range, 1.55 to 8.10kg), respectively. Mortality prior to next-stage operation was 12(9.4%) patients (8[8/42, 19.0%] for the group Ia, 1[1/19, 5.3%] for group Ib, 3[3/33, 9.1%] for group IIa, 0[0/33, 0.0%] for group IIb). There were no significant difference of mortality rate between each subtype groups except group Ia versus group IIb (p=0.008). But, mortality of group Ia was especially higher as compared to sum of other groups (n=8 versus n=4, respectively, p=0.022). On a multivariable analysis, there were no statistically significant risk factors of mortality in aspects of preoperative juxtaductal stenosis, body weight, shunt size/body weight ratio, use of cardiopulmonary bypass, sternotomy incision, position of aortic arch and dosage of aspirin
결론 : The risk of interstage death was shown to be significantly higher in patients with FSV with PA, so these patients should be followed more thoroughly.
책임저자: 박정준
울산대학교 의과대학 서울아산병원 흉부외과학교실 소아심장외과
연락처 : 박원균, Tel: 010-4408-6567 , E-mail : medkyoun@naver.com
