초록접수 현황
| 20F-152 | 구연 발표 |
Surgical treatment of the aortic coarctation depending on the anatomical characteristics
Hyungtae Kim, Kwang Ho Choi, Si Chan Sung
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital
Purpose : To evaluate early and long-term results of surgical treatment of the aortic coarctation (CoA) depending on the anatomical characteristics.
Methods : A retrospective clinical review of the patients with CoA undergoing surgery between March 2011 and August 2020 was performed. We devise a surgical classification to separate various entities in the spectrum of CoA: type I= tightly packed all three head vessels; type II= left subclavian artery separated from two other head vessels; type III= all three head vessels separated from each other. Each of these types has subtypes: A= without long isthmic portion and B= with long isthmic portion.
Results : One hundred eleven consecutive patients were included. The median age and weight at operation were 8 days and 3.21 kg. Several operative techniques have been performed depending on the anatomical characteristics: extended end-to-end anastomosis (EETE) via sternotomy in 54 (48.6%); EETE via thoracotomy in 12 (10.8%); resection and end-to-side anastomosis in 31 (27.9%); main pulmonary artery patch augmentation in 12 (10.8%); and modified subclavian artery flap technique in 2 patients (1.8%). Early mortality was one case (0.9%), and postoperative complications occurred in 12 patients (10.8%). The mean follow-up duration was 43.9±29.8 months. During follow-up, there were two late deaths (1.8%). Five patients (4.5%) have undergone re-interventions, and three patients (2.7%) have had reoperations for re-stenosis of CoA. All type IA patients (21 patients, 18.9%) have undergone EETE via sternotomy or thoracotomy.
Conclusion : Surgical treatment of CoA depending on the anatomical characteristics is a safe and low-risk procedure, concerning either early and late outcomes.
Methods : A retrospective clinical review of the patients with CoA undergoing surgery between March 2011 and August 2020 was performed. We devise a surgical classification to separate various entities in the spectrum of CoA: type I= tightly packed all three head vessels; type II= left subclavian artery separated from two other head vessels; type III= all three head vessels separated from each other. Each of these types has subtypes: A= without long isthmic portion and B= with long isthmic portion.
Results : One hundred eleven consecutive patients were included. The median age and weight at operation were 8 days and 3.21 kg. Several operative techniques have been performed depending on the anatomical characteristics: extended end-to-end anastomosis (EETE) via sternotomy in 54 (48.6%); EETE via thoracotomy in 12 (10.8%); resection and end-to-side anastomosis in 31 (27.9%); main pulmonary artery patch augmentation in 12 (10.8%); and modified subclavian artery flap technique in 2 patients (1.8%). Early mortality was one case (0.9%), and postoperative complications occurred in 12 patients (10.8%). The mean follow-up duration was 43.9±29.8 months. During follow-up, there were two late deaths (1.8%). Five patients (4.5%) have undergone re-interventions, and three patients (2.7%) have had reoperations for re-stenosis of CoA. All type IA patients (21 patients, 18.9%) have undergone EETE via sternotomy or thoracotomy.
Conclusion : Surgical treatment of CoA depending on the anatomical characteristics is a safe and low-risk procedure, concerning either early and late outcomes.
책임저자: Hyungtae Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital
발표자: Hyungtae Kim, E-mail : 2719k@naver.com