초록접수 현황
| 17F-190 | 포럼 발표 |
Reoperations after Repair of Complete Atrioventricular Septal Defect: A 20-year Single-center Experience
Bongyeon Sohn, M.D., Jae Gun Kwak, M.D., Eung Re Kim, M.D., Jae Hong Lim, M.D., Jooncheol Min, M.D., Woong-Han Kim, M.D.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Our objective was to examine reoperations after initial biventricular repair of complete atrioventricular septal defect (AVSD), and determine the cause of reoperation and late clinical outcome.
Methods : Between 1994 and 2017, 49 patients underwent reoperation at our hospital after prior repair of complete AVSD (total 157 patients, median interval, 2.7 years; range, 1 day to 4566 days). Clinical data were obtained by retrospective review. Operations because of post-operative bleeding and surgical wound problem were excluded.
Results : Indications for reoperation included left atrioventricular valve regurgitation (LAVVR) in 36 patients (73%), subaortic stenosis in 4 (8%), residual septal defect in 5 (10%), and other in 4 (8%). The first reoperation after initial repair of complete AVSD included mitral valve repair in 28 patients (57%), mitral valve replacement in 7, Subaortic fibrous membrane-muscle resection in 5, tricuspid valve surgery in 17. There was no early death within a year after first reoperation. At last follow-up, 97% of survivors were in New York Heart Association functional class I. Overall freedom from additional intervention after first reoperation was 87% at 10 years.
Conclusion : The most common indication for reoperation after initial repair of complete AVSD is LAVVR combined with left ventricular outflow tract obstruction. This study evaluates reoperation after repair of complete AVSD can be performed with acceptable clinical outcome.
Methods : Between 1994 and 2017, 49 patients underwent reoperation at our hospital after prior repair of complete AVSD (total 157 patients, median interval, 2.7 years; range, 1 day to 4566 days). Clinical data were obtained by retrospective review. Operations because of post-operative bleeding and surgical wound problem were excluded.
Results : Indications for reoperation included left atrioventricular valve regurgitation (LAVVR) in 36 patients (73%), subaortic stenosis in 4 (8%), residual septal defect in 5 (10%), and other in 4 (8%). The first reoperation after initial repair of complete AVSD included mitral valve repair in 28 patients (57%), mitral valve replacement in 7, Subaortic fibrous membrane-muscle resection in 5, tricuspid valve surgery in 17. There was no early death within a year after first reoperation. At last follow-up, 97% of survivors were in New York Heart Association functional class I. Overall freedom from additional intervention after first reoperation was 87% at 10 years.
Conclusion : The most common indication for reoperation after initial repair of complete AVSD is LAVVR combined with left ventricular outflow tract obstruction. This study evaluates reoperation after repair of complete AVSD can be performed with acceptable clinical outcome.
책임저자: Woong-Han Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Bongyeon Sohn, E-mail : s.bongyeon@gmail.com