초록접수 현황
| 16F-272 | 구연 발표 |
Long-term Results of Pulmonary Valve Annular Enlargement with Valve Repair in Total Correction of Tetralogy of Fallot
Hyungtae Kim¹, Kwang Ho Choi¹, Hyoung Doo Lee², Gil Ho Ban², Geena Kim², Si Chan Sung¹
¹Department of Thoracic and Cardiovascular Surgery, ²Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Korea
Background : Transannular patch (TAP) enlargement of pulmonary valve (PV) in surgical repair of tetralogy of Fallot (TOF) produces pulmonary regurgitation (PR), which may lead to acute and late functional deterioration of right ventricle. We adopted an operative technique of PV annular enlargement with valve repair in TOF correction to reduce postoperative PR.
Methods : Between April 2000 and August 2005, 43 patients (26 males and 17 females) with TOF/pulmonary stenosis underwent PV annular enlargement with valve repair. The median age and weight at the operation were 14 months and 10.2 kg. Glutaraldehyde (GA)-treated autologous pericardium was used in 31 patients, and Gore-Tex membrane in 12 patients.
Results : There was no operative mortality. Mean postoperative PR grade at discharge was 1.8±0.7 (none or trivial in 10, mild in 25, mild to moderate in 5, and moderate PR in 3 patients), and mean postoperative pressure gradient (PG) through PV was 10.2±13.0mmHg (0-43). Mean F/U duration was 124.8±46.7 months (10-196). During F/U, there was one reoperation, which was for residual VSD closure. There were 3 late deaths, but all late deaths were not related to cardiac origin. Mean PR grade at last F/U echocardiography was 2.6±0.6 (mild in 17, mild to moderate in 8, moderate in 14, moderate to severe in 1, and severe in 3 patients), and mean PG was 23.1±9.7 mmHg (10-49). Risk factors analysis for moderate or more PR at last F/U echocardiography was performed. We could not find any statistically significant risk factor, but there was a tendency of having moderate or more PR in the patient who underwent valve reconstruction with GA-treated autologous pericardium (48.4% vs. 25.0%, p=0.163).
Conclusion : PV annular enlargement with valve reconstruction has a reasonable lone-term results, and the technique using Gore-Tex membrane shows a tendency of having lower PR grade at late F/U comparing with using GA-treated autologous pericardium.
Methods : Between April 2000 and August 2005, 43 patients (26 males and 17 females) with TOF/pulmonary stenosis underwent PV annular enlargement with valve repair. The median age and weight at the operation were 14 months and 10.2 kg. Glutaraldehyde (GA)-treated autologous pericardium was used in 31 patients, and Gore-Tex membrane in 12 patients.
Results : There was no operative mortality. Mean postoperative PR grade at discharge was 1.8±0.7 (none or trivial in 10, mild in 25, mild to moderate in 5, and moderate PR in 3 patients), and mean postoperative pressure gradient (PG) through PV was 10.2±13.0mmHg (0-43). Mean F/U duration was 124.8±46.7 months (10-196). During F/U, there was one reoperation, which was for residual VSD closure. There were 3 late deaths, but all late deaths were not related to cardiac origin. Mean PR grade at last F/U echocardiography was 2.6±0.6 (mild in 17, mild to moderate in 8, moderate in 14, moderate to severe in 1, and severe in 3 patients), and mean PG was 23.1±9.7 mmHg (10-49). Risk factors analysis for moderate or more PR at last F/U echocardiography was performed. We could not find any statistically significant risk factor, but there was a tendency of having moderate or more PR in the patient who underwent valve reconstruction with GA-treated autologous pericardium (48.4% vs. 25.0%, p=0.163).
Conclusion : PV annular enlargement with valve reconstruction has a reasonable lone-term results, and the technique using Gore-Tex membrane shows a tendency of having lower PR grade at late F/U comparing with using GA-treated autologous pericardium.
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: Hyungtae Kim, E-mail : 2719k@naver.com