초록접수 현황
| 20F-042 | 구연 발표 |
The Differential Fate of Proximal Descending Thoracic Aorta in Marfan Patient with Annuloaortic Ectasia
Tae-Hoon Kim1, Ha Lee1, Myeong su Kim1, Seung Jun Song2, Wan Kee Kim2, Suk-Won Song1, Kyung-Jong Yoo3
1 Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3 Department of Thoracic and Cardiovascular Surgery, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3 Department of Thoracic and Cardiovascular Surgery, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : The aim of this study was to investigate the differential fate of proximal descending thoracic aorta (pDTA) in marfan patients with annuloaortic ectaisa (AAE).
Methods : Between 2010 and 2018, 116 consecutive patients underwent aortic root replacement with or without arch repair. Of those, 63 patients without DeBakey type I or III dissection were enrolled. Thirty-nine patients were non-marfan group (group N) and the others (group M, n=24) were patients with marfan syndrome. The smallest diameter of aorta (distal arch ~ pDTA) was measured in each patient and pDTA (mm) divided by the smallest diameter (mm) was calculated as 'dilated ratio of pDTA'.
Results : Overall mortality was 1.6% (1 of 63 patients). The median follow-up and imaging follow-up duration was 34.5 and 12.4 months, respectively. Arch replacement was conducted during root replacement in 38.5% (group N) and 70.8% (group M), respectively. Aorta-related events occurred in 3 (4.8%) patients of Group M (Table 1). 'Dilated ratio of pDTA' was significantly higher in group M (Figure 1A). In group M, freedom from aorta-related event was significantly lower comparing with group N (Log-rank p=0.022, figure 1B). On linear mixed model, marfan syndrome and higher 'dilated ratio of pDTA' were significantly associated with faster growth rate of proximal DTA (Figure 1C).
Conclusion : Considering that aorta-related events can occur in marfan patients with small diameter of pDTA, cautious follow up is needed regardless of the absolute diameter of pDTA and extensive arch replacement may be beneficial in young marfan patients with high 'dilated ratio of pDTA'.
Methods : Between 2010 and 2018, 116 consecutive patients underwent aortic root replacement with or without arch repair. Of those, 63 patients without DeBakey type I or III dissection were enrolled. Thirty-nine patients were non-marfan group (group N) and the others (group M, n=24) were patients with marfan syndrome. The smallest diameter of aorta (distal arch ~ pDTA) was measured in each patient and pDTA (mm) divided by the smallest diameter (mm) was calculated as 'dilated ratio of pDTA'.
Results : Overall mortality was 1.6% (1 of 63 patients). The median follow-up and imaging follow-up duration was 34.5 and 12.4 months, respectively. Arch replacement was conducted during root replacement in 38.5% (group N) and 70.8% (group M), respectively. Aorta-related events occurred in 3 (4.8%) patients of Group M (Table 1). 'Dilated ratio of pDTA' was significantly higher in group M (Figure 1A). In group M, freedom from aorta-related event was significantly lower comparing with group N (Log-rank p=0.022, figure 1B). On linear mixed model, marfan syndrome and higher 'dilated ratio of pDTA' were significantly associated with faster growth rate of proximal DTA (Figure 1C).
Conclusion : Considering that aorta-related events can occur in marfan patients with small diameter of pDTA, cautious follow up is needed regardless of the absolute diameter of pDTA and extensive arch replacement may be beneficial in young marfan patients with high 'dilated ratio of pDTA'.
책임저자: Suk-Won Song
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Tae-Hoon Kim , E-mail : airtech2@yuhs.ac