Park, Samina
(Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
,
Hwang, Ho-Young
(Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
,
Kim, Kyung-Hwan
(Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
,
Kim, Ki-Bong
(Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
,
Ahn, Hyuk
(Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
Background: The long-term results of homografts used in systemic circulation are controversial. We assessed the long-term results of using a cryopreserved homograft for an aortic root or aorta and its branch replacement. Materials and Methods: From June 1995 to January 2010, 23 patients (male:female...
Background: The long-term results of homografts used in systemic circulation are controversial. We assessed the long-term results of using a cryopreserved homograft for an aortic root or aorta and its branch replacement. Materials and Methods: From June 1995 to January 2010, 23 patients (male:female=15:8, $45.4{\pm}15.6$ years) underwent a homograft replacement in the aortic position. The surgical techniques used were aortic root replacement in 15 patients and aortic graft interposition in 8 patients. Indications for the use of a homograft were systemic vasculitis (n=15) and complicated infection (n=8). The duration of clinical follow-up was $65{\pm}58$ months. Results: Early mortality occurred in 2 patients (8.7%). Perioperative complications included atrial arrhythmia (n=3), acute renal failure (n=3), and low cardiac output syndrome (n=2). Late mortality occurred in 6 patients (26.1%). The overall survival rates at 5 and 10 years were 66.3% and 59.6%, respectively. Six patients (28.6%) suffered from homograft-related complications. Conclusion: Early results of homograft replacement in aortic position were favorable. However, close long-term follow-up is required due to the high rate of homograft-related events.
Background: The long-term results of homografts used in systemic circulation are controversial. We assessed the long-term results of using a cryopreserved homograft for an aortic root or aorta and its branch replacement. Materials and Methods: From June 1995 to January 2010, 23 patients (male:female=15:8, $45.4{\pm}15.6$ years) underwent a homograft replacement in the aortic position. The surgical techniques used were aortic root replacement in 15 patients and aortic graft interposition in 8 patients. Indications for the use of a homograft were systemic vasculitis (n=15) and complicated infection (n=8). The duration of clinical follow-up was $65{\pm}58$ months. Results: Early mortality occurred in 2 patients (8.7%). Perioperative complications included atrial arrhythmia (n=3), acute renal failure (n=3), and low cardiac output syndrome (n=2). Late mortality occurred in 6 patients (26.1%). The overall survival rates at 5 and 10 years were 66.3% and 59.6%, respectively. Six patients (28.6%) suffered from homograft-related complications. Conclusion: Early results of homograft replacement in aortic position were favorable. However, close long-term follow-up is required due to the high rate of homograft-related events.
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제안 방법
However, its use has been limited due to the lack of availability of donors and concern about long-term durability [5,9]. The aims of this study were to evaluate the long-term results of surgery performed with a cryopreserved homograft in the aortic position including the aortic root or aorta and its branch, and to compare those according to the indications and surgical techniques used.
The patients underwent regular postoperative follow-up through the outpatient clinic at 3 or 4 month intervals, and they were contacted by telephone for confirmation of their condition if the last clinic visit was not conducted at the scheduled time. Clinical follow-up was closed on September 30, 2010.
대상 데이터
Indications for the use of a homograft were1) systemic vasculitis (n=15) such as Behçet disease (n=14) and Takayasu arteritis (n=1) and2) complicated infection (n=8) involving the aortic root (n=3) or aorta and its branch (n=5). The surgical techniques used were aortic root replacement in 15 patients and aortic graft interposition in 8 patients.
데이터처리
Comparison between the 2 groups was performed using the Fisher’s exact test for categorical variables and Student’s t test for continuous variables.
Comparison between the 2 groups was performed using the Fisher’s exact test for categorical variables and Student’s t test for continuous variables. Survival rates were estimated using the Kaplan-Meier method and comparisons between the 2 groups were performed using the log-rank test. A p-value of less than 0.
성능/효과
The present study demonstrated two main findings about cryopreserved homograft replacement in the aortic position with acute and chronic inflammation. First, the early results of a cryopreserved homograft used in the aortic position including the aortic root or aorta and its branch were acceptable with an early mortality rate of 8.7%. Second, homo- graft-related events occurred more frequently in patients who underwent homograft replacement due to systemic vasculitis, although long-term survival was similar regardless of the indications or types of operation.
참고문헌 (15)
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