초록접수 현황
| 16F-038 | 구연 발표 |
Staged Correction of Mixed-type Total Anomalous Pulmonary Venous Returns
Hunbo Shim¹, Ji-Hyuk Yang¹, I-seok Kang², June Huh², Jin Young Song², Tae-Gook Jun¹
¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, ²Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : The small size of the pulmonary veins in infants possess the risk of pulmonary vein obstruction (PVO) after surgical repair of mixed-type total anomalous pulmonary venous return (TAPVR). The repair strategy for these patients is still controversial. We aimed to describe outcome of our strategy that delayed total correction after first partial correction.
Methods : We reviewed the data of patients who underwent surgical correction for mixed-type TAPVR. Of 103 patients with TAPVR, 11 patients had mixed-type TAPVR with biventricular physiology. Of 11 patients, we retrospectively reviewed 7 patients who have completed two-staged correction. Major pulmonary venous confluent common chamber except left upper pulmonary vein (LUPV) were anastomosed to left side of heart first, followed by anastomosis between remained LUPV and left atrial auricle.
Results : Median weight, age and LUPV size were 4.3kg (3.5-5.4kg), 40 days (20-103 days) and 4.5mm (3.0-5.4mm) at first operation and 12.2kg (8.5-31.5kg), 1165 days (280-3250 days) and 9.8mm (8.0-12.3mm) at second operation, respectively. Median Qp/Qs was 1.6 (1.2 to 1.6) and cardiothoracic ratio was 0.52 (0.49-0.57). Median time interval between first and second operation was 1094 days (196-3226 days). There was no mortality or major morbidity after both operations. All seven patients who underwent two-staged correction were in good condition without clinical symptoms of PVO.
Conclusion : Our result suggests for patients with mixed-type TAPVR, it is a viable option to leave the isolated left upper vein uncorrected at infancy, and perform second operation when the LUPV grows adequately for anastomosis.
Methods : We reviewed the data of patients who underwent surgical correction for mixed-type TAPVR. Of 103 patients with TAPVR, 11 patients had mixed-type TAPVR with biventricular physiology. Of 11 patients, we retrospectively reviewed 7 patients who have completed two-staged correction. Major pulmonary venous confluent common chamber except left upper pulmonary vein (LUPV) were anastomosed to left side of heart first, followed by anastomosis between remained LUPV and left atrial auricle.
Results : Median weight, age and LUPV size were 4.3kg (3.5-5.4kg), 40 days (20-103 days) and 4.5mm (3.0-5.4mm) at first operation and 12.2kg (8.5-31.5kg), 1165 days (280-3250 days) and 9.8mm (8.0-12.3mm) at second operation, respectively. Median Qp/Qs was 1.6 (1.2 to 1.6) and cardiothoracic ratio was 0.52 (0.49-0.57). Median time interval between first and second operation was 1094 days (196-3226 days). There was no mortality or major morbidity after both operations. All seven patients who underwent two-staged correction were in good condition without clinical symptoms of PVO.
Conclusion : Our result suggests for patients with mixed-type TAPVR, it is a viable option to leave the isolated left upper vein uncorrected at infancy, and perform second operation when the LUPV grows adequately for anastomosis.
책임저자: Tae-Gook Jun
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Hunbo Shim, E-mail : hbsimsmc@gmail.com