초록접수 현황
| 15F-216 | 구연 발표 |
Branch Pulmonary Artery Peel Operation in Redo Congenital Cardiac Surgeries
김형태¹, 성시찬¹, 최광호¹, 이형두², 반길호², 김지나²
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실¹, 부산대학교 의과대학 양산부산대학교병원 소아과학교실²
Background : Reoperation is inevitably required for the patients who underwent branch pulmonary artery (PA) reconstruction with artificial materials in case of absent unilateral or bilateral intrapericardial PAs. In re-operation, we only enucleated the previous conduit from surrounding fibrotic tissue (Peel), and then we used this peel tissue as a new conduit.
Methods : Between February 2009 and November 2014, 3 patients underwent branch PA peel operation. Ages at the operation were 19, 26, and 96 months old, respectively. Branch PA peel operation were at right side in 1 patient, left side in 1, and both sides in 1. The original diagnoses were pulmonary atresia with ventricular septal defect, major aortopulmonary collateral arteries in 1 patient, tetralogy of Fallot with absent pulmonary valve syndrome in 1, and hemitruncus with coarctation of aorta in 1. Explanted conduits in branch pulmonary arteries were a bovine pericardial roll in 2, and a polytetrafluoroethylene tube graft in 1 patient. Concomitant surgeries were right ventricle (RV)-to-PA conduit change in 2 patients. The interval between the prior operation and the peel operation were 54, 18, and 19 months.
Results : Follow-up durations after branch PA peel operation were 72, 70, and 8.5 months, respectively. During follow-up, there was no re-operation or re-intervention for the branch PA stenosis. There was no aneurysmal formation and significant stenosis. We were able to identify the growth of peel conduit after the operation with follow-up echocardiography or computed tomography angiography in all 3 patients.
Conclusion : The branch PA peel operation can simplify a PA angioplasty in redo-operation. The peel tissue surrounding previous conduit can be used as a new native tissue conduit.
Methods : Between February 2009 and November 2014, 3 patients underwent branch PA peel operation. Ages at the operation were 19, 26, and 96 months old, respectively. Branch PA peel operation were at right side in 1 patient, left side in 1, and both sides in 1. The original diagnoses were pulmonary atresia with ventricular septal defect, major aortopulmonary collateral arteries in 1 patient, tetralogy of Fallot with absent pulmonary valve syndrome in 1, and hemitruncus with coarctation of aorta in 1. Explanted conduits in branch pulmonary arteries were a bovine pericardial roll in 2, and a polytetrafluoroethylene tube graft in 1 patient. Concomitant surgeries were right ventricle (RV)-to-PA conduit change in 2 patients. The interval between the prior operation and the peel operation were 54, 18, and 19 months.
Results : Follow-up durations after branch PA peel operation were 72, 70, and 8.5 months, respectively. During follow-up, there was no re-operation or re-intervention for the branch PA stenosis. There was no aneurysmal formation and significant stenosis. We were able to identify the growth of peel conduit after the operation with follow-up echocardiography or computed tomography angiography in all 3 patients.
Conclusion : The branch PA peel operation can simplify a PA angioplasty in redo-operation. The peel tissue surrounding previous conduit can be used as a new native tissue conduit.
책임저자: 성시찬
부산대학교 의과대학 양산부산대학교병원 흉부외과학교실
연락처 : 김형태, Tel: 055-360-2127 , E-mail : 2719k@naver.com
