한빛사논문, 상위피인용논문
- 조회1,092
Abstract
Implications for Optimal Timing of Pulmonary Valve Replacement
Cheul Lee, MD,* Yang Min Kim, MD,† Chang-Ha Lee, MD,* Jae Gun Kwak, MD,* Chun Soo Park, MD,* Jin Young Song, MD,‡ Woo-Sup Shim, MD,‡ Eun Young Choi, MD,‡ Sang Yun Lee, MD,‡ Jae Suk Baek, MD‡
From the *Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea; †Department of Radiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea; and the ‡Department of Pediatric Cardiology, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea.
Reprint requests and correspondence: Dr. Chang-Ha Lee
Abstract .
Objectives The objectives of this study were to evaluate outcomes of pulmonary valve replacement (PVR) in patients with chronic pulmonary regurgitation (PR) and to better define the optimal timing of PVR.
Background Although PVR is effective in reducing right ventricular (RV) volume overload in patients with chronic PR, the optimal timing of PVR is not well defined.
Methods A total of 170 patients who underwent PVR between January 1998 and March 2011 for chronic PR were retrospectively analyzed. To define the optimal timing of PVR, pre-operative and post-operative cardiac magnetic resonance imaging (MRI) data (n = 67) were analyzed.
Results The median age at the time of PVR was 16.7 years. Follow-up completeness was 95%, and the median follow-up duration was 5.9 years. Overall and event-free survival at 10 years was 98% and 70%, respectively. Post-operative MRI showed significant reduction in RV volumes and significant improvement in biventricular function. Receiver-operating characteristic curve analysis revealed a cutoff value of 168 ml/m2 for non-normalization of RV end-diastolic volume index (EDVI) and 80 ml/m2 for RV end-systolic volume index (ESVI). Cutoff values for optimal outcome (normalized RV volumes and function) were 163 ml/m2 for RV EDVI and 80 ml/m2 for RV ESVI. Higher pre-operative RV ESVI was identified as a sole independent risk factor for suboptimal outcome.
Conclusions Midterm outcomes of PVR in patients with chronic PR were acceptable. PVR should be considered before RV EDVI exceeds 163 ml/m2 or RV ESVI exceeds 80 ml/m2, with more attention to RV ESVI.
Key Words: magnetic resonance imaging, pulmonary regurgitation, pulmonary valve replacement, surgery, tetralogy of Fallot논문정보
- Research article
- 2012년 09월 (BRIC 등록일 )
- 국내 연구진
- 60회 이상 인용된 논문 (상위피인용논문 등록일 2015-09-30)
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