초록접수 현황
| 16F-223 | 포럼 발표 |
Comprarison of the Outcome after Surgical Procedures for Repair of Partial Anomalous Pulmonary Venous Return with Sinus Venosus-type Atrial Septal Defect: Incidence of Postoperative Arrhythmia
Yu-Jin Kwak¹, Kay-Hyun Park², Cheong Lim²
¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, ²Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea
Background : Partial anomalous pulmonary venous return (PAPVR) draining into the superior vena cave (SVC) or right atrium (RA) has been repaired with various techniques. Many techniques have been described for correcting partial anomalous pulmonary venous drainage to avoid the possible complications of stenosis of the systemic or pulmonary venous return, residual shunt of arrhythmias. We investigated the outcome of the repair of this anomaly.
Methods : From January 2006 to July 2016, 51 patients underwent a surgical correction due to sinus venosus-type atrial septal defect (ASD) with PAPVR. Of them, 21 patients underwent a Warden procedure for repair of PAPVR to the SVC in the Seoul National University Hospital including the Seoul National University Bundang Hospital. Their median age at the time of the operation was 5.5 years (range, 17 days to 59 years). Follow-up data were obtained through a review of medical records and correspondence with the patients’ cardiologists. The mean follow-up duration was 5.5 ± 5.1 years (range, 7 months to 10 years).
Results : One patient died of a heart failure and severe pulmonary hypertension after a repair of PAPVR. One patient had transient postoperative sinus arrhythmia. 2 patients were in Atrial fibrillation even before the surgery. One patient developed sick sinus syndrome within 8 years after the Warden procedure. Re-operation for pulmonary venous pathway obstruction was required in 2 patients. All patients were in regular sinus rhythm in the latest electrocardiography.
Conclusion : PAPVR repairs can lead to late arrhythmias such as atrial fibrillation of atrial flutter. In the literature, the Warden procedure has an incidence of arrhythmias from 0% to 23%. According to our results, it didn’t occur arrhythmias regardless of operation. The Warden procedure is a safe and effective surgical option for repair of PAPVR to the SVC in terms of preserving the sinus node function and non-obstructive pulmonary venous pathway.
Methods : From January 2006 to July 2016, 51 patients underwent a surgical correction due to sinus venosus-type atrial septal defect (ASD) with PAPVR. Of them, 21 patients underwent a Warden procedure for repair of PAPVR to the SVC in the Seoul National University Hospital including the Seoul National University Bundang Hospital. Their median age at the time of the operation was 5.5 years (range, 17 days to 59 years). Follow-up data were obtained through a review of medical records and correspondence with the patients’ cardiologists. The mean follow-up duration was 5.5 ± 5.1 years (range, 7 months to 10 years).
Results : One patient died of a heart failure and severe pulmonary hypertension after a repair of PAPVR. One patient had transient postoperative sinus arrhythmia. 2 patients were in Atrial fibrillation even before the surgery. One patient developed sick sinus syndrome within 8 years after the Warden procedure. Re-operation for pulmonary venous pathway obstruction was required in 2 patients. All patients were in regular sinus rhythm in the latest electrocardiography.
Conclusion : PAPVR repairs can lead to late arrhythmias such as atrial fibrillation of atrial flutter. In the literature, the Warden procedure has an incidence of arrhythmias from 0% to 23%. According to our results, it didn’t occur arrhythmias regardless of operation. The Warden procedure is a safe and effective surgical option for repair of PAPVR to the SVC in terms of preserving the sinus node function and non-obstructive pulmonary venous pathway.
책임저자: Cheong Lim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea
발표자: Yu-Jin Kwak, E-mail : jun2yu@hanmail.net