막형 PTFE 단엽판막을 이용한 우심실 유출로 확장수술

Abstract

Background: We studied the effect of membranous ePTFE(expanded polytetrafluoroethylene, Goretex) monocusp valve, known to lessen pseudointimal formation, on the right ventricular outflow tract(RVOT). Material and method: From May, 1996 to February, 1997, we operated 47 patients who received surgery on RVOT in whom we could measure the right ventricular pressure until the post-operative day 1. There were two groups: the comparative group with 19 patients using membranous Goretex monocusp valves and the ontrol group with 28 patients not using Goretex for the reconstruction of RVOT. Two groups did not show statistically significant differences in age, body weight, and McGoon ratio(p>0.05). The previous surgery was performed 19 times in the control group and 22 times in the comparative group. The RVOT reconstructions were performed by the methods of reparation a l`etage ventriculaire(REV) in 2 cases, RV to PA connection in 8 cases, redo-RVOT patch enlargement in 2, and RVOT patch enlargement in 16 cases of the control group. The comparative group had REV operation in 5 cases, Rastelli procedure in 6, redo-RVOT patch enlargement in 5, RVOT patch enlargement in 3 cases. Result: The comparative group showed significant difference shorter duration of indweling chest tube compared to the control group(p<0.04). No eminent significances were found on the aortic cross clamp time and the total bypass time. On the postoperative 7th day, right/left ventricular pressure ratio and RVOT pressure gradient were not different. During the follow-up, pulmonary insufficiency was significantly different between the two groups(p<0.04). One patient in the comparative group was died due to sepsis. Conclusion: We found that the effects of membranous Goretex monocusp valve on the RVOT was good in early results with a reduced pulmonary insufficiency. Continuous long-term follow-up study should be performed on the matter of the membranow valve function and late stenosis. Keywords: 1. Ventricular outflow obstruction 2. Pulmonary valve 3. Polytetrafluoroethylene