초록접수 현황
| 20F-124 | 구연 발표 |
Outcome and risk factor of surgery for infective aortopathy:A single center experience.
Young Su Kim, Yang Hyun Cho, Kiick Sung
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Surgically treated infective aortopathy has various epidemiology and progression but not clearly established. So, we analyzed our single center experience of operation for infective aortopathy.
Methods : Between November 1994 and December 2019, we conducted study on patients who had surgery for infectious aortopathy including infectious aorta with or without aneurysm, and graft infection. Exclusion criteria were under 18 years old, aortitis such as takayasu arteritis or giant cell arteritis, and the main problem was infective endocarditis. The primary outcome was overall mortality and the secondary outcomes were 30 day mortality and postoperative complication. In addition, we also analyzed the factors that affect overall mortality.
Results : Total 64 patients were enrolled in the study. Overall mortality was 34.4% (22pts), of which 30 day mortality was 12.5% (8pts). Aorto-esophageal fistula was accompanied by 14 patients (21.9%) and all of them required combined esophageal surgery. Seven patients needed reoperation due to recurrent leakage. Reoperation due to graft infection occurred in 6 patients (9.4%). The presence of esophageal fistula was risk factor for overall mortality. (Hazard Ratio, 2.70, 95% confidence interval, 1.13-6.45; p=0.03) In the Kaplan-Meier and log rank test, estimated 1 year survival was also better in the group without fistula than in the group with fistula. (76.4±6.3 vs. 54.5±13.8; p=0.02)
Conclusion : Surgical treatment of infectious aortopathy has shown acceptable results. When esophageal fistula is coexisted, a combine operation should always be considered and longer term antibiotics management and more careful treatment are required.
Methods : Between November 1994 and December 2019, we conducted study on patients who had surgery for infectious aortopathy including infectious aorta with or without aneurysm, and graft infection. Exclusion criteria were under 18 years old, aortitis such as takayasu arteritis or giant cell arteritis, and the main problem was infective endocarditis. The primary outcome was overall mortality and the secondary outcomes were 30 day mortality and postoperative complication. In addition, we also analyzed the factors that affect overall mortality.
Results : Total 64 patients were enrolled in the study. Overall mortality was 34.4% (22pts), of which 30 day mortality was 12.5% (8pts). Aorto-esophageal fistula was accompanied by 14 patients (21.9%) and all of them required combined esophageal surgery. Seven patients needed reoperation due to recurrent leakage. Reoperation due to graft infection occurred in 6 patients (9.4%). The presence of esophageal fistula was risk factor for overall mortality. (Hazard Ratio, 2.70, 95% confidence interval, 1.13-6.45; p=0.03) In the Kaplan-Meier and log rank test, estimated 1 year survival was also better in the group without fistula than in the group with fistula. (76.4±6.3 vs. 54.5±13.8; p=0.02)
Conclusion : Surgical treatment of infectious aortopathy has shown acceptable results. When esophageal fistula is coexisted, a combine operation should always be considered and longer term antibiotics management and more careful treatment are required.
책임저자: Kiick Sung
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Young Su, E-mail : ys9709@gmail.com