초록접수 현황
| 16F-218 | 구연 발표 |
Mid-term Results of Expanded Polytetrafluoroethylene-valved Conduit in Right Ventricular Outflow Reconstruction; Single Center Experience
Kwang Ho Choi, MD¹, Si Chan Sung, MD¹ Hyungtae Kim, MD¹ , Hyung Doo Lee, MD², Gil Ho Ban, MD², Geena Kim, MD², Hoon Ko, 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 : Right ventricular outflow tract (RVOT) valved conduit is used for unobstructed connection between right ventricle and pulmonary artery. In selection of RVOT conduit, conduit survival longevity without significant dysfunction is most important. But RVOT conduit selection is very limited in our country.
Methods : From the April 2005 to March 2016, 73 ePTFE valved conduit were implanted in 64 patients. We excluded 8 cases for palliative surgery. Finally, 65 cases in 61 patients were enrolled this study. The mean age was 50.8 ± 68.6 months and body weight was 16.3 ± 16.2Kg. The small size conduit (10mm~16mm) were used in 38 cases and tricuspid valved conduit was used in 50 cases. Follow-up duration was 40.0 ± 31.2 months (1.8~130.1 months). We defined the conduit failure when RVOT pressure gradient(PG) was above 50mmHg or moderate or severe conduit valve regurgitation.
Results : There were 1 in hospital death and 2 late deaths. All were not related to the conduit. The mean PG at discharge was 12.7 ± 9.5mmHg and 35.3 ± 21.8mmHg in latest follow-up. There was no different in PG between tricuspid valve group and non-tricuspid valve group at discharge (p=0.440, 12.1 vs 14.4) but latest PG was different between two groups (p<0.001, 28.6 vs 58.5) The freedom from conduit failure due to stenosis at 1, 7 years was 98.4%, 68.9% and 96.6%, 94.6% in regurgitation. The freedom from conduit failure at 1, 7 years was 95.0%, 65.2%. Conduit explantation was performed in 6 patients. The 5 years freedom from conduit explantation was 88.6%, 80.5% in small size group, 96.0% in large size group, 88.8% in tricuspid group and 78.6% in non-tricuspid group.
Conclusion : The expanded polytetrafluoroethylene (ePTFE) valved conduit have reasonable results and longevity. But there is a tendency of increasing right ventricular outflow tract pressure gradient with time. Further follow-up should be needed.
Methods : From the April 2005 to March 2016, 73 ePTFE valved conduit were implanted in 64 patients. We excluded 8 cases for palliative surgery. Finally, 65 cases in 61 patients were enrolled this study. The mean age was 50.8 ± 68.6 months and body weight was 16.3 ± 16.2Kg. The small size conduit (10mm~16mm) were used in 38 cases and tricuspid valved conduit was used in 50 cases. Follow-up duration was 40.0 ± 31.2 months (1.8~130.1 months). We defined the conduit failure when RVOT pressure gradient(PG) was above 50mmHg or moderate or severe conduit valve regurgitation.
Results : There were 1 in hospital death and 2 late deaths. All were not related to the conduit. The mean PG at discharge was 12.7 ± 9.5mmHg and 35.3 ± 21.8mmHg in latest follow-up. There was no different in PG between tricuspid valve group and non-tricuspid valve group at discharge (p=0.440, 12.1 vs 14.4) but latest PG was different between two groups (p<0.001, 28.6 vs 58.5) The freedom from conduit failure due to stenosis at 1, 7 years was 98.4%, 68.9% and 96.6%, 94.6% in regurgitation. The freedom from conduit failure at 1, 7 years was 95.0%, 65.2%. Conduit explantation was performed in 6 patients. The 5 years freedom from conduit explantation was 88.6%, 80.5% in small size group, 96.0% in large size group, 88.8% in tricuspid group and 78.6% in non-tricuspid group.
Conclusion : The expanded polytetrafluoroethylene (ePTFE) valved conduit have reasonable results and longevity. But there is a tendency of increasing right ventricular outflow tract pressure gradient with time. Further follow-up should be needed.
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