초록접수 현황
| 19F-272 | 구연 발표 |
Surgical Outcomes of Infective Endocarditis : 20-Year Experience of Children’s Hospital
Jae Hong Lee, Sungkyu Cho, Jae Gun Kwak, Woong-Han Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Surgical outcomes of infective endocarditis (IE) in children have rarely reported. We analyzed patient characteristics and surgical outcomes of IE in our institution.
Methods : We retrospectively reviewed records of 64 cases of 58 consecutive patients who underwent surgical treatment for IE, from 2000 to 2019. Four patients had repeated surgeries due to IE more than once during the study period.
Results : Median age at the operation were 11.2 years (range: 3 days~36.3 years). Median duration from diagnosis to surgery was 15 days (range: 0~247 days). Thirty-three patients had prior cardiac surgery and 49 patients had congenital heart defects. Gram-positive groups were most common (n=40).Native valves were involved in 33 patients. Valve-sparing surgery was performd successfully in 26 patients. There were two in-hospital mortalities. There was one late-mortality due to non-cardiac cause. Twelve patients underwent reoperations after IE operation because of valve failure (n=5), prostheses failure (n=5), and recurrent IE (n=2). Perivalvular extension (PVE) (p=0.001) was significant risk factor for reoperation. PVE (p=0.001) and body weight at the time of operation(p=0.019) were significant risk factors for not-saving native valve. Freedom from reoperation rate and recurrent IE rate at 5, 10, and 15 years were 83.8%, 76.3% and 57.8%, and 95.8%, 92.7% and 83.5%, respectively.
Conclusion : Considering somatic growth in children, our early- and long-term surgical outcomes of IE in children were acceptable. PVE was significant risk factor for reoperation and significant risk factor for not-saving native valve. Body weight at the operation was significant factor for not-saving native valve.
Methods : We retrospectively reviewed records of 64 cases of 58 consecutive patients who underwent surgical treatment for IE, from 2000 to 2019. Four patients had repeated surgeries due to IE more than once during the study period.
Results : Median age at the operation were 11.2 years (range: 3 days~36.3 years). Median duration from diagnosis to surgery was 15 days (range: 0~247 days). Thirty-three patients had prior cardiac surgery and 49 patients had congenital heart defects. Gram-positive groups were most common (n=40).Native valves were involved in 33 patients. Valve-sparing surgery was performd successfully in 26 patients. There were two in-hospital mortalities. There was one late-mortality due to non-cardiac cause. Twelve patients underwent reoperations after IE operation because of valve failure (n=5), prostheses failure (n=5), and recurrent IE (n=2). Perivalvular extension (PVE) (p=0.001) was significant risk factor for reoperation. PVE (p=0.001) and body weight at the time of operation(p=0.019) were significant risk factors for not-saving native valve. Freedom from reoperation rate and recurrent IE rate at 5, 10, and 15 years were 83.8%, 76.3% and 57.8%, and 95.8%, 92.7% and 83.5%, respectively.
Conclusion : Considering somatic growth in children, our early- and long-term surgical outcomes of IE in children were acceptable. PVE was significant risk factor for reoperation and significant risk factor for not-saving native valve. Body weight at the operation was significant factor for not-saving native valve.
책임저자: Jae Gun Kwak
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Jae Hong Lee, E-mail : holyjh85@naver.com