초록접수 현황
| 17F-119 | 구연 발표 |
Outcomes of Neonatal Repair in Tetralogy of Fallot with Ductal Dependent Pulmonary Atresia
Chang-Ha Lee¹, Sungkyu Cho¹, Eun Seok Choi², Yong Jin Kim¹
¹Department of Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea., ²Divisions of Pediatric Cardiac Surgery and Pediatric Cardiology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Most of patients with tetralogy of Fallot with ductal dependent pulmonary atresia (TOF-PA) should be needed any intervention soon after birth, which includes one stage repair or palliation. We report the current outcomes of one stage repair in the neonates.
Methods : From May 2004 to April 2017, 28 neonates with TOF-PA underwent one stage repair. Median age and body weight at operation were 17 days (12 - 29 days) and 3.0 kg (2.2 - 4.2 kg). Median preoperative Nakata Index was 110 (62 - 189). According to the morphology, right ventricular outflow tract reconstruction (RVOTR) was performed by the interposition of a non-valved autopericardial roll (n = 13), transjunctional RVOTR (n = 10), RVOTR using the left atrial auricle (n = 3), and REV type RVOTR (n = 2).
Results : There is no hospital mortality and median hospital stay after repair was 19 days (6 - 112 days). Delayed sternal closure was performed in 5 patients. The median follow-up duration was 71 months (1.4 - 151 months). There were 2 late deaths and freedom from mortality was 92% at 10 years. During follow-up, various postoperative interventions were necessary in 23 patients, including a catheter intervention (n = 20) and reoperation (n = 15) mainly for the RVOT problems.
Conclusion : One stage repair in neonates with TOF-PA seems to be performed safely and with acceptable mid-term outcomes. However, various interventions after repair should be inevitable in many patients for optimizing the RVOT.
Methods : From May 2004 to April 2017, 28 neonates with TOF-PA underwent one stage repair. Median age and body weight at operation were 17 days (12 - 29 days) and 3.0 kg (2.2 - 4.2 kg). Median preoperative Nakata Index was 110 (62 - 189). According to the morphology, right ventricular outflow tract reconstruction (RVOTR) was performed by the interposition of a non-valved autopericardial roll (n = 13), transjunctional RVOTR (n = 10), RVOTR using the left atrial auricle (n = 3), and REV type RVOTR (n = 2).
Results : There is no hospital mortality and median hospital stay after repair was 19 days (6 - 112 days). Delayed sternal closure was performed in 5 patients. The median follow-up duration was 71 months (1.4 - 151 months). There were 2 late deaths and freedom from mortality was 92% at 10 years. During follow-up, various postoperative interventions were necessary in 23 patients, including a catheter intervention (n = 20) and reoperation (n = 15) mainly for the RVOT problems.
Conclusion : One stage repair in neonates with TOF-PA seems to be performed safely and with acceptable mid-term outcomes. However, various interventions after repair should be inevitable in many patients for optimizing the RVOT.
책임저자: Chang-Ha Lee
Department of Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
발표자: Chang-Ha Lee, E-mail : leechha@gmail.com