초록접수 현황
| 16F-216 | 구연 발표 |
Does the Coronary Reimplantation after Neoarortic Reconstruction in Arterial Switch Operation Increase the Incidence of Aortic Regurgitation?
Kwang Ho Choi, MD¹, Si Chan Sung, MD¹, Hyungtae Kim, MD¹, Hyung Doo Lee, MD², Gil Ho Ban, MD², Geena Kim, MD²
¹Department of Thoracic and Cardiovascular Surgery, ²Department of Pediatric Cardiology, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Korea
Background : The coronary reimplantation after neoarortic reconstruction in arterial switch operation had an advantage of selecting accurate coronary transfer site easily with a distended aortic root. But this technique had a disadvantage of potential possibility of neoaortic valve injury. This study presents our experience of this technique to determine the outcomes of the neoaortic valve regurgitation after arterial switch operation (ASO).
Methods : Between March in 2003 and March in 2016, 128 patients underwent ASO. We excluded who underwent aortocoronary flap technique(9), and palliative ASO(1). Finally, 118 patients were enrolled this study. After hospital discharge 4 patients have been lost to follow-up. 64 patients were simple TGA and great artery relationships were anteroposterior in 89 patients. The coronary artery anatomy was usual in 84 patients. The mean age was 11.9±17.5 days, and mean body weight was 3.4±0.5Kg.
Results : Follow-up duration was 57.1± 37.9 months. There were 3 in hospital mortalities due to severe capillary leakage and low cardiac output syndrome in 2 patients and sepsis and multi-organ failure in 1 patient. There were no late death and coronary artery intervention. In the postoperative echocardiography, 46 patients showed neoaortic valve regurgitation.(trivial in 29, mild in 17, moderate in 1). At the last follow-up echocardiography, 55 patients showed neoaortic valve regurgitation.(trivial in 26, mild in 28, moderate in 1) Intraoperative coronary artery revision was not required in all patients. 11 patients required reoperation(LVOT related 2, RVOT related 2, diaphragm palsy 2, LV-RA shunt 2, LLL segmentectomy 1, foreign body removal 1, hybrid VSD closure 1). The freedom from more than moderate regurgitaiton was 96.3% at 10 years.
Conclusion : Coroanry artery reimplantation after neoaortic reconstruction can be performed safely without any early and late coronary event or coronary intervention. The incidence of more than moderate neoaortic valve regurgitation was rare. Also there was no coronary event during follow-up
Methods : Between March in 2003 and March in 2016, 128 patients underwent ASO. We excluded who underwent aortocoronary flap technique(9), and palliative ASO(1). Finally, 118 patients were enrolled this study. After hospital discharge 4 patients have been lost to follow-up. 64 patients were simple TGA and great artery relationships were anteroposterior in 89 patients. The coronary artery anatomy was usual in 84 patients. The mean age was 11.9±17.5 days, and mean body weight was 3.4±0.5Kg.
Results : Follow-up duration was 57.1± 37.9 months. There were 3 in hospital mortalities due to severe capillary leakage and low cardiac output syndrome in 2 patients and sepsis and multi-organ failure in 1 patient. There were no late death and coronary artery intervention. In the postoperative echocardiography, 46 patients showed neoaortic valve regurgitation.(trivial in 29, mild in 17, moderate in 1). At the last follow-up echocardiography, 55 patients showed neoaortic valve regurgitation.(trivial in 26, mild in 28, moderate in 1) Intraoperative coronary artery revision was not required in all patients. 11 patients required reoperation(LVOT related 2, RVOT related 2, diaphragm palsy 2, LV-RA shunt 2, LLL segmentectomy 1, foreign body removal 1, hybrid VSD closure 1). The freedom from more than moderate regurgitaiton was 96.3% at 10 years.
Conclusion : Coroanry artery reimplantation after neoaortic reconstruction can be performed safely without any early and late coronary event or coronary intervention. The incidence of more than moderate neoaortic valve regurgitation was rare. Also there was no coronary event during follow-up
책임저자: Si Chan Sung
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Korea
발표자: Kwang Ho Choi, E-mail : ppippo77@gmail.com