초록접수 현황
| 16F-241 | 구연 발표 |
Results of Aortic Valve Leaflet Extension Technique in Patients with Congenital Heart Disease
Sungkyu Cho, Chang-Ha Lee, Eun Seok Choi
Department of Cardiovascular Suergery, Sejong General Hospital, Gyeonggi-do, Korea
Background : We evaluated the efficacy of aortic valve leaflet extension in the treatment of patients with congenital aoritc valvular pathology.
Methods : Twenty-six patients (7 from abroad) underwent aortic valve leaflet extension from May 2000 to March 2016. The mean age was 19. 4 ± 9.9 years (range, 2.9 to 40.8 years). Sixty five percent (17 of 26) were less than 19 years old at operation. The diagnosis included ventricular septal defect(12 patients), aortic regurgitation(7), aortic steno insufficiency(2), coarctation of aorta with ventricular septal defect(1), double outlet right ventricle(1), pulmonary atresia with intact ventricular septum(1), and transposition of great arteries(1). Nine patients(34.6 %) had previous cardiac operations(n = 8) or percutaneous intervention (n = 3). Leaflet extensions were performed on 1 cusp in 16 patients, 2 cusp in 5, and 3 cusp in 5.
Results : The mean follow-up duration was 5.6 ± 4.2 years. There was no mortality. Comparison of preoperative and post-repair echocardiograms demonstrated reductions in aortic regurgitation grade (decreased from 3.1 ± 1.0 to 0.9 ± 0.6; p <0.001), and left ventricular end-diastolic dimensions Z-score (decreased from 2.64 ± 1.48 to 1.14 ± 0.38; p <0.001) Four patients required reoperation and prosthetic replacement for aortic valve. The remaining of patients are well with a mean aortic regurgitation grade of 1.6 ± 0.7(scale, 0 to 4) . Freedom from reoperation was 93.3 ± 6.4 % at 2 years, 86.7 % at 5 years, and 75.8 % at 10 years. The reoperation rate by Kaplan-Meier log rank was higher in patients who had bicuspid valve (p <0.0001), and patients who had significant aortic stenosis before operation (p = 0.014).
Conclusion : Leaflet extension technique is a valid option with acceptable results for aortic regurgitation from a congenital valvular pathology. Bicuspid aortic valve and significant aortic stenosis could be risk factors for reoperation of aortic valve.
Methods : Twenty-six patients (7 from abroad) underwent aortic valve leaflet extension from May 2000 to March 2016. The mean age was 19. 4 ± 9.9 years (range, 2.9 to 40.8 years). Sixty five percent (17 of 26) were less than 19 years old at operation. The diagnosis included ventricular septal defect(12 patients), aortic regurgitation(7), aortic steno insufficiency(2), coarctation of aorta with ventricular septal defect(1), double outlet right ventricle(1), pulmonary atresia with intact ventricular septum(1), and transposition of great arteries(1). Nine patients(34.6 %) had previous cardiac operations(n = 8) or percutaneous intervention (n = 3). Leaflet extensions were performed on 1 cusp in 16 patients, 2 cusp in 5, and 3 cusp in 5.
Results : The mean follow-up duration was 5.6 ± 4.2 years. There was no mortality. Comparison of preoperative and post-repair echocardiograms demonstrated reductions in aortic regurgitation grade (decreased from 3.1 ± 1.0 to 0.9 ± 0.6; p <0.001), and left ventricular end-diastolic dimensions Z-score (decreased from 2.64 ± 1.48 to 1.14 ± 0.38; p <0.001) Four patients required reoperation and prosthetic replacement for aortic valve. The remaining of patients are well with a mean aortic regurgitation grade of 1.6 ± 0.7(scale, 0 to 4) . Freedom from reoperation was 93.3 ± 6.4 % at 2 years, 86.7 % at 5 years, and 75.8 % at 10 years. The reoperation rate by Kaplan-Meier log rank was higher in patients who had bicuspid valve (p <0.0001), and patients who had significant aortic stenosis before operation (p = 0.014).
Conclusion : Leaflet extension technique is a valid option with acceptable results for aortic regurgitation from a congenital valvular pathology. Bicuspid aortic valve and significant aortic stenosis could be risk factors for reoperation of aortic valve.
책임저자: Chang-Ha Lee
Department of Cardiovascular Suergery, Sejong General Hospital, Gyeonggi-do, Korea
발표자: Sungkyu Cho, E-mail : csk1022@hanmail.net