Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Repair of Aortic Coarctation and Arch Hypoplasia in Infants and Children

영아 및 소아에서의 대동맥궁의 형성부전을 포함한 대동맥 교약증의 수술요법 -21년간의 수술 경험-

  • Sin, Yun-Cheol (Dept.of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National Uiversity College of Medicine) ;
  • Lee, Jeong-Ryeol (Dept.of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National Uiversity College of Medicine) ;
  • Kim, Yong-Jin (Dept.of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National Uiversity College of Medicine) ;
  • No, Jun-Ryang (Dept.of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National Uiversity College of Medicine)
  • 신윤철 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 이정렬 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 김용진 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 노준량 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실)
  • Published : 1996.03.01
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Abstract

We have reviewed 157 cases of coarctation of aorta in the age of infancy and children from March 1973 to december 1994. Patients were 9) males and 64 females, and their age ranged from one month to fifteen years (23.8 $\pm$ 41.6months) with 113 infant cases. In the infantile age, congestive heart failure was the most common chief complaint (781113), and above that age, asymptom was most common (15/44). Isolated coarctation was present in 31 patients, and 9 patients had additional atrial septal defect (group I), 73 patients had associated ventricular septal defect (group II), and 44 patients had associated complex intracardiac lesions(group III). Aortic arch hypoplasia was present in 17 patients. , The operations perf'ormed were subclavian flap angioplasty in 71 patients, resection and anastomosis in 32 patients, patch aortoplasty in 26 patients, resd extended end-!o-end anastomosis in 27 patients, and direct angioplasty with resection of web in 1 patient. The early mortality was 17.2% (27/157) and re-coarctation rate was 18.0% (281157). The most common complication was respiratory problem in infants and postoperative hypertension in children.

1973년 3월부터 1994년 12월까지 수술을 시행한 영아 및 소아 연령의 대동맥 교약증 157례를분석하 였다. 남아가 93명 여아가 64명 이 었고 연령은 1개 월부터 15세까지로 평균 23.8 $\pm$ 41.6개월이 었다. 영아 기의 주증상은 심부전이 었고(781113) 그 이상의 연령 에서 무증상이 빈번하였다(15/44). 단독 대동맥 교약증은 31례의 환아에서 있었고, 9례의 환아에서 심방중격결손이 있었으며(I군), 73명 의 환아에서 심실중격결손이 동반됐고(ll군), 44명의 환아에서 복잡 심기형이 있었다(III군).대동맥궁 의 형 성 부전은 17례의 환아에서 발견되었다. 수술은 71례의 환아에서 쇄골하동맥 편 성형술이 시행됐고, 단순 단단문합술이 32례, 조직편 대동맥 성형술이 26례, 확장 단단문합술이 27례, 기타 1례가 있었다, 전체 수술사망률은 17.2% (27/157)이었고, 재 협착률은 18.0% (28/157)이 었다. 수술합병증은 영아기에 서는 호흡기질환이, 그 이상의 연령 에서는 고혈압이 가장 많았다.

Keywords

References

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