Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Study of Composite Valve Graft Replacement of the Aortic Root

대동맥 근부 복합 인공 판막 도관 치환술에 관한 임상적 고찰

  • Park, Kwon-Jae (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital) ;
  • Woo, Jong-Soo (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital) ;
  • Cho, Gwang-Jo (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital) ;
  • Bang, Jung-Hee (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital) ;
  • Jeong, Sang-Seok (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital)
  • 박권재 (동아대학교병원 흉부외과) ;
  • 우종수 (동아대학교병원 흉부외과) ;
  • 조광조 (동아대학교병원 흉부외과) ;
  • 방정희 (동아대학교병원 흉부외과) ;
  • 정상석 (동아대학교병원 흉부외과)
  • Received : 2010.01.11
  • Accepted : 2010.03.23
  • Published : 2010.06.05
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Abstract

Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

배경: 복합 인공 판막 도관(composite valve graft) 치환술은 다양한 대동맥 근부 질환들에 사용되어 왔다. 이 연구의 목적은 이 술기에 대한 중기 결과를 알아보는 데 있다. 대상 및 방법: 1992년부터 2009년까지 대동맥 근부 복합 인공 판막 도관 치환술을 받은 39명의 환자를 대상으로 후향적 조사를 하였다. 환자들의 평균 나이는 $49.2{\pm}16.4$세였고, 평균 추적 관찰 기간은 $64.2{\pm}53.4$개월이었다(최대 기간, 176개월). 결과: 4명(8.6%)의 병원 내 사망이 있었고 모두 응급 대동맥 박리인 경우였다. 4명의 만기 사망이 있었는데 2명은 잔류 대동맥류, 1명은 경막하 출혈, 1명은 판막 주위 역류가 원인이었다. 생존율은 각각 1년, 5년, 10년에 93.5%, 85.0%, 85.0%였다. 추적 관찰 기간 동안 3명의 환자에서 뇌혈관 사고가 발생하였고, 뇌혈관 사고로부터의 자유율은 각각 1년, 5년, 10년에 97.0%, 92.0%, 80.0%였다. 모든 뇌혈관사고는 출혈과 연관된 합병증이었다. 결론: 복합 인공 판막 도관을 이용한 대동맥 근부 치환술은 좋은 결과를 보여 왔다. 그러므로 이 술기는 다양한 대동맥 근부 질환의 치료에 좋은 방법이라 할 수 있다.

Keywords

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