초록접수 현황
| 19F-183 | 구연 발표 |
Long-Term Outcomes of Arterial Switch Operation for Taussig-Bing Anomaly: Consideration About Lecompte Procedure According to Relationship of Great Arteries
Jae Hong Lim, Eung Rae Kim, Chang Ha Lee
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
Purpose : The Taussig-Bing anomaly (TBA) is still challenging to treat because of its anatomic complexity, especially in the relationship of the great arteries and coronary artery anatomy. We aimed to investigate the long-term outcomes of arterial switch operation and Lecompte procedure for Taussig-Bing anomaly.
Methods : A retrospective review was performed for all TBA patients who underwent biventricular repair from January 2000 to April 2019. Total 30 patients (median: 0.57 months, range: 0.40-1.13 months) underwent biventricular repair for Taussig-Bing anomaly. All patients underwent arterial switch operation (ASO) except one patient who underwent Kawashima operation (intraventricular rerouting) and two patients who died after the first stage pulmonary artery banding procedure for biventricular repair. Lecompte procedure was performed a total 24 of 27 patients who underwent arterial switch operation.
Results : Twenty-seven patients underwent ASO. And concomitant repair of artic arch obstruction was performed in 6 patients (20%). Complex coronary anatomy was in 6 patients (20%). Six patients had pulmonary artery banding for staged repair (20%). Median follow-up duration was 99.9 months (IR: 19.4-164.7 months). Hospital mortality was 13.3% (n = 4). Survival rate at 1 year was 86.3% and the 10-year survival rate was 76.8%. Mortality was confined to the first operative year (4 of 6 patients). 24 patients underwent Lecompte procedure during ASO. 10 of 30 patients had a side by side relationship of great arteries. There was no difference survival rate between groups who underwent Lecompte procedure or not. But aortic root dilatation, ascending aorta deformity and left pulmonary artery stretching are significantly more in side by side relationship of great arteries group than aorta anterior and rightward group when we did Lecompte procedure (p=0.004, p=0.011, p=0.05).
Conclusion : Correction of TBA with ASO has favorable outcomes. But Lecompte procedure-related great arteries deformity was significantly higher in side by side relationship of great arteries group. ASO without Lecompte procedure is also a considerable option when we repair TBA anomaly with side by side relationship of great arteries.
Methods : A retrospective review was performed for all TBA patients who underwent biventricular repair from January 2000 to April 2019. Total 30 patients (median: 0.57 months, range: 0.40-1.13 months) underwent biventricular repair for Taussig-Bing anomaly. All patients underwent arterial switch operation (ASO) except one patient who underwent Kawashima operation (intraventricular rerouting) and two patients who died after the first stage pulmonary artery banding procedure for biventricular repair. Lecompte procedure was performed a total 24 of 27 patients who underwent arterial switch operation.
Results : Twenty-seven patients underwent ASO. And concomitant repair of artic arch obstruction was performed in 6 patients (20%). Complex coronary anatomy was in 6 patients (20%). Six patients had pulmonary artery banding for staged repair (20%). Median follow-up duration was 99.9 months (IR: 19.4-164.7 months). Hospital mortality was 13.3% (n = 4). Survival rate at 1 year was 86.3% and the 10-year survival rate was 76.8%. Mortality was confined to the first operative year (4 of 6 patients). 24 patients underwent Lecompte procedure during ASO. 10 of 30 patients had a side by side relationship of great arteries. There was no difference survival rate between groups who underwent Lecompte procedure or not. But aortic root dilatation, ascending aorta deformity and left pulmonary artery stretching are significantly more in side by side relationship of great arteries group than aorta anterior and rightward group when we did Lecompte procedure (p=0.004, p=0.011, p=0.05).
Conclusion : Correction of TBA with ASO has favorable outcomes. But Lecompte procedure-related great arteries deformity was significantly higher in side by side relationship of great arteries group. ASO without Lecompte procedure is also a considerable option when we repair TBA anomaly with side by side relationship of great arteries.
첨부파일 : Taussig-Bing anomaly.pptx
책임저자: Chang Ha Lee
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
발표자: Jae Hong Lim, E-mail : stlim38@hanmail.net