초록접수 현황
| 17F-267 | 구연 미채택시 포럼 발표 |
Surgical Interventions after the Fontan Operation
Won Kyoun Park, Eun Seok Choi, Chun Soo Park, Tae-Jin Yun
Department of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Although the Fontan operation (FO) is considered as being the final procedure for patients with a functionally single ventricle (FSV), inherent anatomic disposition of FSV may necessitate further surgical interventions in post-Fontan patients.
Methods : Among the 389 patients who underwent the FO between December 1999 and July 2017 in our institution, 43 patients (26 males) underwent 51 additional surgical procedures. Cox proportional hazards model was fitted to identify risk factors for decreased time to each reoperation.
Results : After the FO, various surgical interventions were performed, including extra-cardiac conduit Fontan conversion after other-type Fontan procedures in 8, pacemaker implantation in 10, atrioventricular valve repair or replacement in 7, additional fenestration in 7, heart transplantation in 7, systemic outflow tract relief operation in 4 and others in 8. Freedom from any reoperation at 5 year and 10 years after the FO were 94.6% ± 1.3% and 91% ± 1.7%, respectively. Median interval between the Fontan operation and post-Fontan reoperation was 88.6 months (range, 0.7 to 265.8). On Cox hazard modeling, corrected transposition of great arteries was identified as a risk factor for PPM implantation after FO in pacemaker implantation group (HR: 7.286, 95% CI 2.045-25.960, P=0.002)
Conclusion : In this study, some patients underwent FO was received addition surgical interventions. More closed observation and examination are needed in patients after FO.
Methods : Among the 389 patients who underwent the FO between December 1999 and July 2017 in our institution, 43 patients (26 males) underwent 51 additional surgical procedures. Cox proportional hazards model was fitted to identify risk factors for decreased time to each reoperation.
Results : After the FO, various surgical interventions were performed, including extra-cardiac conduit Fontan conversion after other-type Fontan procedures in 8, pacemaker implantation in 10, atrioventricular valve repair or replacement in 7, additional fenestration in 7, heart transplantation in 7, systemic outflow tract relief operation in 4 and others in 8. Freedom from any reoperation at 5 year and 10 years after the FO were 94.6% ± 1.3% and 91% ± 1.7%, respectively. Median interval between the Fontan operation and post-Fontan reoperation was 88.6 months (range, 0.7 to 265.8). On Cox hazard modeling, corrected transposition of great arteries was identified as a risk factor for PPM implantation after FO in pacemaker implantation group (HR: 7.286, 95% CI 2.045-25.960, P=0.002)
Conclusion : In this study, some patients underwent FO was received addition surgical interventions. More closed observation and examination are needed in patients after FO.
첨부파일 : reoperation after FO.pptx
책임저자: Tae-Jin Yun
Department of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Won Kyoun Park, E-mail : medkyoun@naver.com