초록접수 현황
| 19F-276 | 구연 발표 |
Biventricular Repair of Atrioventricular Septal Defect Associated With Tetralogy of Fallot or Double-Outlet Right Ventricle: 15-Year Experience in a Single Center
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 : Biventricular repair(BVR) of atrioventricular septal defect (AVSD) and tetralogy of Fallot (TOF) or double outlet right ventricle (DORV) is still challenging due to its relatively high mortality and reoperation rates. We reported the clinical outcome of BVR for AVSD associated with TOF or DORV in our institution.
Methods : From 2004 to 2019, 11 patients with AVSD associated TOF (n=6) or DORV (n=5) underwent BVR; of which, one patient had staged surgical repair. Seven patients underwent pulmonary valve preservation and restoration strategies with avoidance of right ventriculotomy, external conduit and transannular patch widening. Data were obtained by reviewing inpatient and outpatient medical records at our institution.
Results : Mean age and body-weight at the time of operation were 15.4 months (range, 3.3 to 37.5) and 8.9 kg (range, 3.5 to 11.7), respectively. There was no in-hospital mortality. Mean follow-up period was 58.8 months (range, 1.4 to 157.4) and there was only one mortality case during the follow-up. The cause of mortality was infection of non-cardiac cause. Palliative procedure was performed in one patient before BVR. Reoperation was required due to progressive mitral regurgitation in one patient. Significant right ventricular outflow tract obstruction (RVOTO) was detected in 2 patients before discharge. But RVOTO has been improved during follow-up. There were no significant left ventricular outflow tract obstruction and atrioventricular valve regurgitation during follow-up.
Conclusion : Our surgical results showed no early mortality and one late mortality. Single-stage BVR in selected patients with AVSD and TOF or DORV could be reasonable surgical option.
Methods : From 2004 to 2019, 11 patients with AVSD associated TOF (n=6) or DORV (n=5) underwent BVR; of which, one patient had staged surgical repair. Seven patients underwent pulmonary valve preservation and restoration strategies with avoidance of right ventriculotomy, external conduit and transannular patch widening. Data were obtained by reviewing inpatient and outpatient medical records at our institution.
Results : Mean age and body-weight at the time of operation were 15.4 months (range, 3.3 to 37.5) and 8.9 kg (range, 3.5 to 11.7), respectively. There was no in-hospital mortality. Mean follow-up period was 58.8 months (range, 1.4 to 157.4) and there was only one mortality case during the follow-up. The cause of mortality was infection of non-cardiac cause. Palliative procedure was performed in one patient before BVR. Reoperation was required due to progressive mitral regurgitation in one patient. Significant right ventricular outflow tract obstruction (RVOTO) was detected in 2 patients before discharge. But RVOTO has been improved during follow-up. There were no significant left ventricular outflow tract obstruction and atrioventricular valve regurgitation during follow-up.
Conclusion : Our surgical results showed no early mortality and one late mortality. Single-stage BVR in selected patients with AVSD and TOF or DORV could be reasonable surgical option.
책임저자: 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
발표자: Jae Hong Lee, E-mail : holyjh85@naver.com