ニイナミ　ヒロシ   NIINAMI Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
言語種別	英語
発表タイトル	Long-term Results of Intraventricular Repair of Transposition of the Great Arteries with Left Ventricular Outflow Tract Obstruction: Comparison of Rastelli Operation and REV Operation
会議名	The 26th Annual Meeting of the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS 2018 MOSCOW)
主催者	The Asian Society for Cardiovascular and Thoracic Surgery
学会区分	国際学会及び海外の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎FURUTA Akihisa, MATSUMURA Goki, NIINAMI Hiroshi
発表年月日	2018/05/25
開催地 （都市, 国名）	Moscow, RUSSIA
概要	Objectives: The purpose of this study is to evaluate the long-term results of transposition of the great arteries (TGA) with left ventricular obstruction and compare between Rastelli operation and REV operation. Methods: Retrospective study was conducted on 71 patients with TGA with LVOTO who underwent intraventricular rerouting between 1980 and 2014. Total cohort was divided into two groups: Rastelli group (n = 47) and REV group (n = 24). The early and long-term results were compared between two groups. Results: Median age was 5.4 years in Rastelli group and 3.8 years in REV group. Mean body weight was 19.1±8.7 kg in Rastelli group and 15.1±6.9 kg in REV group. Mean pressure gradient in left ventricular outflow tract was 59.1±19.9 mmHg in Rastelli group and 48.1±15.0 mmHg. LVOTO included subvalvular stenosis in 7 cases (Rastelli: 3, REV: 4), valvular stenosis in 30 (Rastelli: 21, REV: 9), both subvalvular and valvular stenosis in 19 (Rastelli: 10, REV: 9) and pulmonary atresia in 15 (Rastelli: 12, REV: 3). Mean aortic cross-clamp time was 91.8±36.1 minutes in Rastelli group, and 94.4 minutes in REV group. Early mortality was 6.4% in Rastelli group and 8.8 % in REV group. Mean follow-up period was 15.2± 9.9 years. The overall survival at 20 years was 74.7±6.6% in Rastelli group and 74.7±6.6 % in REV group (Long-rank test, p= 0.052). Freedom from reoperation at 20 years was 30.1±8.9 % in Rastelli group and 72.5±13.3% in REV group (Long-rank test, p= 0.0007). Conclusion: The long-term results of intraventricular rerouting for TGA with LVOTO was favorable in terms of survival. There were no significant differences between groups except for the rate of reoperation.