초록접수 현황
| 20F-202 | 구연 발표 |
Clinical Outcome of Leaflet Patch Augmentation for Left Atrioventricular Valve Reoperation Following Repair of Complete Atrioventricular Septal Defect
Yujin Kwak, Jae-Hong Lee, Jooncheol Min, Sungkyu Cho, Jae Gun Kwak, Woong-Han Kim
Department of Thoracic and Cardiovascular Surgery, Seoul University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Outcomes of repair of complete atrioventricular septal defects (cAVSDs) have improved over the last decades. However, the need for reoperation following correction of cAVSD remains a major concern caused by left-sided atrioventricular valve regurgitation (LAVVR). We evaluated surgical outcome of reoperation for LAVVR repaired by leaflet patch augmentation.
Methods : Between April 2010 and April 2020, 10 consecutive patients with cAVSD underwent reoperation for LAVVR after repair of cAVSD by leaflet patch augmentation. Mean age at repair of cAVSD was 5.7±5.2 months and mean age at reoperation for LAVVR was 22.2±16.3 months. There were 2 patients with double orifice of LAAV and 3 patients underwent palliative surgery like as pulmonary artery banding before repair of cAVSD.
Results : The mean follow-up duration was 3.0±2.2 years after LAAV repair. There was no operative and late mortality. 4 patients underwent LAAV leaflet patch augmentation for severe LAVVR, 5 for moderate LAVVR, and 1 patient for mild LAVVR. Patients also had LAVV stenosis for moderate stenosis in 3, and severe in one patient. Follow-up echocardiographic examination demonstrated significant improvement in LAVVR (p < 0.01). Left ventricular end diastolic dimension decreased from an average 30.0±4.7 mm preoperatively to 27.1±5.8 mm postoperatively (p < 0.01). Two patients finally underwent valve replacement after leaflet patch augmentation caused by progression of LAVV regurgitation and stenosis.
Conclusion : Leaflet patch augmentation results in significant clinical improvement. Especially in complex LAVV pathology with both regurgitation and stenosis, Leaflet patch augmentation might be considered surgical option in young children before valve replacement associated with valve-related morbidity.
Methods : Between April 2010 and April 2020, 10 consecutive patients with cAVSD underwent reoperation for LAVVR after repair of cAVSD by leaflet patch augmentation. Mean age at repair of cAVSD was 5.7±5.2 months and mean age at reoperation for LAVVR was 22.2±16.3 months. There were 2 patients with double orifice of LAAV and 3 patients underwent palliative surgery like as pulmonary artery banding before repair of cAVSD.
Results : The mean follow-up duration was 3.0±2.2 years after LAAV repair. There was no operative and late mortality. 4 patients underwent LAAV leaflet patch augmentation for severe LAVVR, 5 for moderate LAVVR, and 1 patient for mild LAVVR. Patients also had LAVV stenosis for moderate stenosis in 3, and severe in one patient. Follow-up echocardiographic examination demonstrated significant improvement in LAVVR (p < 0.01). Left ventricular end diastolic dimension decreased from an average 30.0±4.7 mm preoperatively to 27.1±5.8 mm postoperatively (p < 0.01). Two patients finally underwent valve replacement after leaflet patch augmentation caused by progression of LAVV regurgitation and stenosis.
Conclusion : Leaflet patch augmentation results in significant clinical improvement. Especially in complex LAVV pathology with both regurgitation and stenosis, Leaflet patch augmentation might be considered surgical option in young children before valve replacement associated with valve-related morbidity.
첨부파일 : 추계 abstract - LAVV.pptx
책임저자: Woong-Han Kim
Department of Thoracic and Cardiovascular Surgery, Seoul University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Yujin Kwak, E-mail : jun2yu@hanmail.net