|
ヒラマツ タケシ
HIRAMATSU Takeshi
平松 健司 所属 医学部 医学科（附属八千代医療センター） 職種 准教授 |
|
| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 招待の有無 | 招待あり |
| 表題 | Long-term Effect of Enlargement of a Ventricular Septal Defect in the Rastelli Procedure. |
| 掲載誌名 | 正式名：Seminars in thoracic and cardiovascular surgery 略 称：Semin Thorac Cardiovasc Surg ISSNコード：15329488/10430679 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 29(2),pp.215-220 |
| 著者・共著者 | Toyoda Yasuyuki, Hiramatsu Takeshi, Nagashima Mitsugi, Matsumura Goki, Yamazaki Kenji |
| 発行年月 | 2017 |
| 概要 | We investigated the effect of ventricular septal defect (VSD) enlargement on long-term surgical results, late arrhythmia, and left ventricular (LV) function in the Rastelli procedure for D-transposition of the great arteries with LV outflow tract obstruction (LVOTO). From 1979 to 2001, 74 patients (D-transposition of the great arteries, n = 56; double outlet right ventricle, n = 18) underwent the Rastelli procedure. In group A, 46 patients underwent the Rastelli procedure with VSD enlargement, and in group B, 28 patients underwent the Rastelli procedure without enlargement. There were no hospital deaths. Actuarial survival at 20 years was 80% in group A and 91% in group B (P = 0.50). Freedom from reoperations at 20 years was 40.1% in group A and 52.0% in group B. Reoperations for LVOTO were performed in 2 patients in both groups. In postoperative catheterization, LV ejection fraction in group A was 57.1% ± 8.7% vs 57.2% ± 8.1% in group B (P = 0.97); LV end-diastolic volume, 150.0% ± 47.2% vs 142.0% ± 36.9% of the normal volume (P = 0.97). In long-term postoperative echocardiography, the pressure gradient of the LV to the aorta was 12.0 ± 12.8 vs 17.7 ± 26.0 mm Hg in groups A and B (P = 0.31). There were no differences between the groups regarding basal rhythms, anti-arrhythmic agents, and pacemaker implantation rate. VSD enlargement in the Rastelli procedure can be safely performed without early mortality and with long-term low mortality and morbidity regarding arrhythmia, LV function, and reoperation for late LVOTO. VSD enlargement should be considered as an option for avoiding long-term LVOTO. |
| DOI | 10.1053/j.semtcvs.2017.03.009 |
| PMID | 28823332 |