초록접수 현황
| 20F-014 | 구연 발표 |
Mini-Access Open Repair of Descending Thoracic Aorta
Younju Rhee, Sung Jun Park, Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Purpose : Open surgical repair is the most effective treatment option for diseases involving descending thoracic aorta (DTA), however, it carries extensive surgical trauma and its associated risks. To overcome these limitations, mini-access open repair of DTA has been adopted.
Methods : The mini-access approach involved (1) limited skin incision (6-10 cm), (2) sparing both latissimus-dorsi and serratus-anterior muscles, (3) saving costal cartilage/bone without cutting and (4) utilization of thoracoscopy and mini-access instruments. All DTA lesions of its longitudinal segments within 10-15cm were candidates for this approach. Femoral access was used for cardiopulmonary bypass (CPB).
Results : Between November 2018 and February 2020, 9 patients (median age 63, range 30-73) received the mini-access DTA replacement. Concomitant distal arch repair was performed in 2 patients. Median CPB and entire procedural times were 79 minutes (inter quartile range [IQR], 67-84 min) and 239 minutes (IQR, 212-254 min), respectively. There was no early death, neurologic complications, re-exploration due to bleeding, wound complications or vascular complications. Only 2 patients required postoperative blood product transfusion (1 p-RBC in each). The median length of postoperative intensive care unit and hospital stays were 1 day (IQR, 1-2 days) and 7 days (IQR, 6-11 days), respectively. The numeric rating scale for surgical site pain (10 being maximum) showed median of 1 (IQR, 1-2) on discharge day.
Conclusion : Our early experiences of mini-access open DTA repair showed acceptable safety and efficiency in selected patients. These results need further validation through experiences from larger samples.
Methods : The mini-access approach involved (1) limited skin incision (6-10 cm), (2) sparing both latissimus-dorsi and serratus-anterior muscles, (3) saving costal cartilage/bone without cutting and (4) utilization of thoracoscopy and mini-access instruments. All DTA lesions of its longitudinal segments within 10-15cm were candidates for this approach. Femoral access was used for cardiopulmonary bypass (CPB).
Results : Between November 2018 and February 2020, 9 patients (median age 63, range 30-73) received the mini-access DTA replacement. Concomitant distal arch repair was performed in 2 patients. Median CPB and entire procedural times were 79 minutes (inter quartile range [IQR], 67-84 min) and 239 minutes (IQR, 212-254 min), respectively. There was no early death, neurologic complications, re-exploration due to bleeding, wound complications or vascular complications. Only 2 patients required postoperative blood product transfusion (1 p-RBC in each). The median length of postoperative intensive care unit and hospital stays were 1 day (IQR, 1-2 days) and 7 days (IQR, 6-11 days), respectively. The numeric rating scale for surgical site pain (10 being maximum) showed median of 1 (IQR, 1-2) on discharge day.
Conclusion : Our early experiences of mini-access open DTA repair showed acceptable safety and efficiency in selected patients. These results need further validation through experiences from larger samples.
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
발표자: Younju Rhee, E-mail : rheeyounju@gmail.com