Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Successful Conversion Arterial Switch Operation after Palliative Senning Operation

고식적 심방 전환술 후 시행한 전환 대혈관 치환술

  • Kim Joon Bum (Department of Thoracic and Cardiovascular Surgery, Asan Medicine Center, University of Ulsan College of Medicine) ;
  • Park Jeong-Jun (Department of Thoracic and Cardiovascular Surgery, Asan Medicine Center, University of Ulsan College of Medicine) ;
  • Chung Sung Ho (Department of Thoracic and Cardiovascular Surgery, Asan Medicine Center, University of Ulsan College of Medicine) ;
  • Park In Sook (Department of Pediatrics, Asan Medicine Center, University of Ulsan College of Medicine) ;
  • Seo Dong Man (Department of Thoracic and Cardiovascular Surgery, Asan Medicine Center, University of Ulsan College of Medicine)
  • 김준범 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 박정준 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 정성호 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 박인숙 (울산대학교 의과대학 서울아산병원 소아과학교실) ;
  • 서동만 (울산대학교 의과대학 서울아산병원 흉부외과학교실)
  • Published : 2006.02.01
Download PDF
⟨ Previous Next ⟩

Abstract

Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.

대혈관 전위, 심실 중격 결손과 이에 의한 심한 폐동맥 폐쇄성 질환을 보여 해부학적 완전 교정이 불가능하다고 판단된 6세 여아에 대하여 고식적인 심방 전환술을 시행한 후 추적 관찰하던 중, 최근 1년 동안 폐혈관 이완제(prostacyclin) 투약을 하고 혈역학적 재평가를 통해 21세에 완전 해부학적 교정인 전환 대혈관전환술 및 심실 중격 결손 폐쇄를 성공적으로 시행하였다 환자는 수술 후 시행한 심초음파 상 폐동맥 압력의 유의한 감소가 관찰되었으며 수술 후 10일째 합병증 없이 퇴원하였다. 환자는 수술 후 3개월째까지 별다른 문제없이 외래 추적 관찰 중이다.

Keywords

References

  1. Heath D, Edwards JE. The pathology of hypertensive pulmonary vascular disease: a description of six grades of structural changes in the pulmonary arteries with special reference to congenital septal defects. Circulation 1958;18: 533-47 https://doi.org/10.1161/01.CIR.18.4.533
  2. Lindesmith GG, Stiles QR, Tucker BL, Gallaher ME, Stanton RE, Meyer BW. The Mustard operation as a palliative procedure. J Thorac Cardiovasc Surg 1972;63:75-8
  3. Burkhart HM, Dearani JA, Williams WG, Puga FJ, Mair DD, Ashburn DA, et al. Late results of palliative atrial switch for transposition, ventricular septal defect, and pulmonary vascular obstructive disease. Ann Thorac Surg 2004;77:464-9 https://doi.org/10.1016/S0003-4975(03)01349-3
  4. Bernhard WF, Dick M, Sloss LJ, Castaneda AR, Nadas AS. The palliative mustard operation for double outlet right ventricle or transposition of the great arteries associated with ventricular septal defect, pulmonary arterial hypertension, and pulmonary vascular obstructive disease. A report of eight patients. Circulation 1976;54:810-7
  5. Mee RB. Severe right ventricular failure after Mustard or Senning operation: two-stage repair: pulmonary artery banding and switch. J Thorac Cardiovasc Surg 1986;92:385-90
  6. Cho YW. Seo DM. Convasion anteial switol opeation for failed senning procedure in TGA with USD. Korean J Tho- rac Cardiovasc Surg 1996;29:86-9
  7. DiSesa VJ, Cohn LH, Grossman W. Management of adults with congenital bidirectional cardiac shunts, cyanosis, and pulmonary vascular obstruction: successful operative repair in 3 patients. Am J Cardiol 1983;51:1495-7 https://doi.org/10.1016/0002-9149(83)90663-X
  8. Rosenzweig EB, Kerstein D, Barst RJ. Long-term prostacyclin for pulmonary hypertension with associated congenital heart defects. Circulation 1999;99:1858-65 https://doi.org/10.1161/01.CIR.99.14.1858