초록접수 현황
| 15F-257 | 포럼 발표 |
Surgical Outcome of Atrial Septal Defect Closure Concomitant with Tricuspid Regurgitation
김홍래, 박정준, 윤태진, 정철현, 이재원, 정성호
울산대학교 의과대학 서울아산병원 흉부외과학교실
Background : The closure of a secundum atrial septal defect could be done by surgical intervention or device. The benefit of surgical intervention is correction of concomitant pathology such as tricuspid regurgitation or atrial fibrillation. The present study was performed to analyze the effect of concomitant TR or A fib in patients with secundum ASD
Methods : Between October 1989 and October 2009, 715 patients underwent surgery for secundum ASD.
Mean age 40.9 ±13.1 and female patients 511 (71.4%). Preoperatively, A fib was 40 (5.59%) and significant TR was 142 (19.9%) Mean follow up duration was 4527.21±1700.22 days
Results : There was no 30 day mortality. The 1-year, 5-year, 10-year and 20-year survival was 99.4%, 96.9%, 94.5% and 81.3%. In multivariate analysis, preoperative significant TR (more than mild) (HR:2.143 CI:1.286-3.572, p=0.003) and preoperative age (HR:1.037, CI:1.018-1.057, p<0.001) were independent risk factors for late mortality. However, in patients with more than mild TR, tricuspid valve repair was not associated with improved long-term survival (p=0.785 ).
Conclusion : Overall survival after ASD closure was acceptable. Preoperative significant TR was strongly correlated with long-term survival, but tricuspid valve repair did not improve the survival. Therefore, early surgery before development of significant TR is important to improve postoperative survival.
Methods : Between October 1989 and October 2009, 715 patients underwent surgery for secundum ASD.
Mean age 40.9 ±13.1 and female patients 511 (71.4%). Preoperatively, A fib was 40 (5.59%) and significant TR was 142 (19.9%) Mean follow up duration was 4527.21±1700.22 days
Results : There was no 30 day mortality. The 1-year, 5-year, 10-year and 20-year survival was 99.4%, 96.9%, 94.5% and 81.3%. In multivariate analysis, preoperative significant TR (more than mild) (HR:2.143 CI:1.286-3.572, p=0.003) and preoperative age (HR:1.037, CI:1.018-1.057, p<0.001) were independent risk factors for late mortality. However, in patients with more than mild TR, tricuspid valve repair was not associated with improved long-term survival (p=0.785 ).
Conclusion : Overall survival after ASD closure was acceptable. Preoperative significant TR was strongly correlated with long-term survival, but tricuspid valve repair did not improve the survival. Therefore, early surgery before development of significant TR is important to improve postoperative survival.
책임저자: 정성호
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 김홍래, Tel: 02-3010-0089 , E-mail : khrjsk@naver.com
