초록접수 현황
| 15F-181 | 구연 발표 |
승모판막치환술에서 Patient-prosthesis Mismatch가 장기 결과에 미치는 영향: Propensity Score 분석
황호영, 최재웅, 오홍철, 김용한, 김경환, 김기봉, 안혁
서울대학교 의과대학 서울대학교병원 흉부외과학교실
목적 : We evaluated the impact of patient-prosthesis mismatch (PPM) following mitral valve replacement on the clinical outcomes using propensity score models.
방법 : 760 patients (51±2years, male:female = 252:508) in whom mitral valve replacement was performed using 3 types of mechanical and 2 types of bioprosthetic valves were enrolled. In vivo data of effective orifice area was drawn from literatures and mitral PPM was defined as an effective orifice area index of equal or less than1.2cm2/m2. The propensity score model was used in 2 ways: the inverse probability of treatment weighting (IPTW)-adjusted multivariable analyses and 1:1 propensity score matching. The duration of the follow-up was 127 months (range 1-276).
결과 : Mitral PPM was identified in 19.3%. The patients with PPM (PPM group, n = 147) were older and had more co-morbidities than those without PPM (NPPM group, n = 613). The 10- and 20-year overall survival and freedom from cardiac death were 83.5% and 71.3%, respectively, and 90.2% and 83.1%, respectively. The IPTW-adjusted multivariable analyses demonstrated that mitral PPM is a significant risk factor for the overall survival and freedom from cardiac death (Hazard ratio [95% confidence interval] = 1.681 [1.139 - 2.482] and 1.673 [1.012 - 2.765], respectively). The propensity score matching extracted 68 pairs. Both overall survival and freedom from cardiac death were also higher in the propensity score-matched NPPM group than in the PPM group (p = 0.039 and 0.017, respectively).
결론 : Mitral PPM significantly affects long-term outcomes after mitral valve replacement in terms of long-term survival and freedom from cardiac death.
방법 : 760 patients (51±2years, male:female = 252:508) in whom mitral valve replacement was performed using 3 types of mechanical and 2 types of bioprosthetic valves were enrolled. In vivo data of effective orifice area was drawn from literatures and mitral PPM was defined as an effective orifice area index of equal or less than1.2cm2/m2. The propensity score model was used in 2 ways: the inverse probability of treatment weighting (IPTW)-adjusted multivariable analyses and 1:1 propensity score matching. The duration of the follow-up was 127 months (range 1-276).
결과 : Mitral PPM was identified in 19.3%. The patients with PPM (PPM group, n = 147) were older and had more co-morbidities than those without PPM (NPPM group, n = 613). The 10- and 20-year overall survival and freedom from cardiac death were 83.5% and 71.3%, respectively, and 90.2% and 83.1%, respectively. The IPTW-adjusted multivariable analyses demonstrated that mitral PPM is a significant risk factor for the overall survival and freedom from cardiac death (Hazard ratio [95% confidence interval] = 1.681 [1.139 - 2.482] and 1.673 [1.012 - 2.765], respectively). The propensity score matching extracted 68 pairs. Both overall survival and freedom from cardiac death were also higher in the propensity score-matched NPPM group than in the PPM group (p = 0.039 and 0.017, respectively).
결론 : Mitral PPM significantly affects long-term outcomes after mitral valve replacement in terms of long-term survival and freedom from cardiac death.
책임저자: 안혁
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 황호영, Tel: 02-2072-2340 , E-mail : scalpel@hanmail.net
