초록접수 현황
| 15F-195 | 포스터 발표 |
Comparison between Mitral Valve Folding and Triangular Resection Technique; Early Clinical Results.
박종명, 제형곤, 이현주, 정혜선, 이지혜, 정현희, 박수영, 이상권
부산대학교 의과대학 부산대학교병원 흉부외과학교실
Background : Currently, leaflet resection or new chorda formation is the most common technique of mitral valve repair for degenerative mitral regurgitation. However both techniques include complicated processes, such as reattachment of leaflet following extensive resection and precise estimation of neochorda. Herein, we compare leaflet folding technique with traditional triangular resection technique.
Methods : Twenty patients with leaflet folding repair (Group F) compared to 28 patients with triangular resection (Group R). A CV5 Gore-Tex suture was placed to the papillary muscle underneath the prolapsing segment as a neochorda. This double armed suture was then used to fold the prolapsed segment into the left ventricle, creating a smooth, broad, non-prolapsed coapting surface on a leaflet with preserved mobility. (Figure 1)
Results : Repair was successful for all patients in both groups and 47 of 48 repairs were finished with minimally invasively approach. Preoperative data such as age, gender and left ventricular ejection fraction were comparable. The estimated mortality calculated with EUROSCORE II system was comparable between groups. (Group R: 1.5%, (interquartile range (IQR), 0.8-2.8), Group F: 1.2%, (IQR: 0.7-2.3), p=0.579) The cardiopulmonary bypass time (Group R: 121 minute, (IQR: 108-153), Group F: 95 minute, (IQR, 85-107), p<0.001) and the cross-clamp times (Group R: 79 minute, (IQR: 69-101), Group F: 60 minute, (IQR, 56-69), p<0.001) was significantly shorter in group F. Postoperative recovery was significantly faster in group F in terms of mechanical ventilation time (Group R: 4 hours, (IQR: 2-6), Group F: 0 hours, (IQR, 0-0), p<0.001), transfusion rate (Group R: 10 (35.7%, Group F: 1 (5%), p<0.001), and length of stay (Group R: 5 days, (IQR: 4-8), Group F: 4 days, (IQR, 3-5), p<0.012).
Conclusion : This simplified mitral valve folding technique might minimize morbidity and facilitate the minimally invasive mitral valve repair.
Methods : Twenty patients with leaflet folding repair (Group F) compared to 28 patients with triangular resection (Group R). A CV5 Gore-Tex suture was placed to the papillary muscle underneath the prolapsing segment as a neochorda. This double armed suture was then used to fold the prolapsed segment into the left ventricle, creating a smooth, broad, non-prolapsed coapting surface on a leaflet with preserved mobility. (Figure 1)
Results : Repair was successful for all patients in both groups and 47 of 48 repairs were finished with minimally invasively approach. Preoperative data such as age, gender and left ventricular ejection fraction were comparable. The estimated mortality calculated with EUROSCORE II system was comparable between groups. (Group R: 1.5%, (interquartile range (IQR), 0.8-2.8), Group F: 1.2%, (IQR: 0.7-2.3), p=0.579) The cardiopulmonary bypass time (Group R: 121 minute, (IQR: 108-153), Group F: 95 minute, (IQR, 85-107), p<0.001) and the cross-clamp times (Group R: 79 minute, (IQR: 69-101), Group F: 60 minute, (IQR, 56-69), p<0.001) was significantly shorter in group F. Postoperative recovery was significantly faster in group F in terms of mechanical ventilation time (Group R: 4 hours, (IQR: 2-6), Group F: 0 hours, (IQR, 0-0), p<0.001), transfusion rate (Group R: 10 (35.7%, Group F: 1 (5%), p<0.001), and length of stay (Group R: 5 days, (IQR: 4-8), Group F: 4 days, (IQR, 3-5), p<0.012).
Conclusion : This simplified mitral valve folding technique might minimize morbidity and facilitate the minimally invasive mitral valve repair.
책임저자: 제형곤
부산대학교 의과대학 부산대학교병원 흉부외과학교실
연락처 : 박종명, Tel: 055-360-2127 , E-mail : jehg7332@gmail.com
