초록접수 현황
| 16F-235 | 구연 발표 |
Growth of the Peripheral Pulmonary Arteries in Patients with Non-confluent Central Pulmonary Artery and Ductus-dependent Pulmonary Circulation
Won Kyoun Park, Jong yoon Park, Chun Soo Park, Jeong-Jun Park, Tae-Jin Yun
Department of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
Background : Patients with non-confluent central pulmonary artery (CPA) and ductus-dependent pulmonary circulation may undergo multiple surgical and catheter interventions for the pulmonary arteries after confluent central pulmonary artery is reconstructed
Methods : Between 2005 and 2016, 16 patients (10 males, 6 with functionally single ventricle) with non-confluent CPA underwent surgical interventions for the reconstruction of CPA. Median age at operation was 26 days (range, 6 to 345). Pulmonary blood flow to the disconnected pulmonary artery was supplied by the left ductus in 8 and by the bilateral ductus in 8. Surgical techniques for the reconstruction of the CPA were pericardial roll interposition in 5 and direct anastomosis of the peripheral PAs with or without anterior wall patch augmentation in 11.
Results : There were no early mortality and 4 late mortality (4/16, 25%). Median reoperations or interventions for peripheral pulmonary arteries were 2 (range 0 to 7). Overall survival and Freedom from surgical or catheter intervention for PA stenosis at 1 year were 87.5±8.3% and 25±10.8%, respectively. On Cox proportional hazards modeling, bilateral ductus at initial diagnosis was identified as a risk factors for early reoperation or intervention (HR: 4.93, 95% CI: 1.29-18.85, P=0.02)
Conclusion : In patients with non-confluent CPA with ductus-dependent pulmonary circulation were almost required additional procedure after initial surgical intervention
Methods : Between 2005 and 2016, 16 patients (10 males, 6 with functionally single ventricle) with non-confluent CPA underwent surgical interventions for the reconstruction of CPA. Median age at operation was 26 days (range, 6 to 345). Pulmonary blood flow to the disconnected pulmonary artery was supplied by the left ductus in 8 and by the bilateral ductus in 8. Surgical techniques for the reconstruction of the CPA were pericardial roll interposition in 5 and direct anastomosis of the peripheral PAs with or without anterior wall patch augmentation in 11.
Results : There were no early mortality and 4 late mortality (4/16, 25%). Median reoperations or interventions for peripheral pulmonary arteries were 2 (range 0 to 7). Overall survival and Freedom from surgical or catheter intervention for PA stenosis at 1 year were 87.5±8.3% and 25±10.8%, respectively. On Cox proportional hazards modeling, bilateral ductus at initial diagnosis was identified as a risk factors for early reoperation or intervention (HR: 4.93, 95% CI: 1.29-18.85, P=0.02)
Conclusion : In patients with non-confluent CPA with ductus-dependent pulmonary circulation were almost required additional procedure after initial surgical intervention
책임저자: Tae-Jin Yun
Department of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
발표자: Won Kyoun Park, E-mail : medkyoun@naver.com