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분리 대동맥판막하 협착증 수술의 임상적 고찰

Other Titles
 Clinical Analysis of Surgical Results for Discrete Subaortic Stenosis 
Authors
 유송현  ;  임상현  ;  홍유선  ;  박영환  ;  장병철  ;  강면식 
Citation
 Korean Journal of Thoracic and Cardiovascular Surgery (대한흉부외과학회지), Vol.38(8) : 545-550, 2005 
Journal Title
Korean Journal of Thoracic and Cardiovascular Surgery(대한흉부외과학회지)
ISSN
 0301-2859 
Issue Date
2005
MeSH
Ventricular outflow tract obstruction, left ; Aortic stenosis, subvalvular ; Ventricle ; Surgical operation
Keywords
Ventricular outflow tract obstruction, left ; Aortic stenosis, subvalvular ; Ventricle ; Surgical operation
Abstract
Background: Discrete subaortic stenosis is known to recur frequently even after surgical resection. We retrospectively reviewed the preoperative and postoperative changes in pressure gradient through left ventricular outflow tract, and the recurrence rate.
Material and Method: Between September 1984 and December 2004, 34 patients underwent surgical treatment. Mean age of patients was 17.1±15.2 years and 19 patients (55.9%) were male. 16 patients (47.1%) had previous operations and associated diseases were aortic regurgitation (11), coarctation of aorta (3), and others.
Result: Immediate postoperative peak pressure gradient was significantly lower than preoperative peak pressure gradient (21.8 mmHg vs 75.8 mmHg, p<0.01). Peak pressure gradient measured after 50.3 months of follow up was 20.2 mmHg, which was also significantly lower than that of preoperative value but not significantly different from that of immediate postoperative value. There was no surgical mortality but one patient developed cerebral infarction. Mean follow up duration was 69.8±54.6 months. During this period, 5 patients (14.7%) had reoperation, 3 (8.8%) of whom were due to recurred subaortic stenosis. We found no risk factors for recurrence and survival for free from reoperation was 76.4%.
Conclusion: Excision of subaortic membrane combined with or without myectomy in discrete subaortic stenosis showed sufficient relief of left ventricular outflow tract obstruction with low mortality and morbidity, but careful long term follow up is necessary for recurrence, since it is not predictable.
Files in This Item:
T200500535.pdf Download
DOI
OAK-2005-03684
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Du Cheol(강두철)
Kang, Meyun Shick(강면식)
Park, Young Hwan(박영환) ORCID logo https://orcid.org/0000-0001-9802-8017
Lim, Sang Hyun(임상현)
Chang, Byung Chul(장병철)
Hong, You Sun(홍유선)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/150011
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