Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Transplantation of an Extremely Oversized Heart after. Prolonged Extracorporeal Membrane Oxygenation Assistance in a 3-month-old Infant with Congenital Heart Disease

선천성 심질환을 가진 3개월 소아에서 장기간의 체외 막형 산소화 보조 후 몸무게 차이가 큰 공여자-수용자간 심장 이식

  • Cho, Hyun-Jin (Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Dong-Man (Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jhang, Won-Kyoung (Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Chun-Soo (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine) ;
  • Kim, Young-Hwee (Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine)
  • 조현진 (울산대학교 의과대학 서울아산병원 소아심장외과학교실) ;
  • 서동만 (울산대학교 의과대학 서울아산병원 소아심장외과학교실) ;
  • 장원경 (울산대학교 의과대학 서울아산병원 소아심장외과학교실) ;
  • 박천수 (서울대학교병원 의과대학 흉부외과학교실) ;
  • 김영휘 (울산대학교 의과대학 서울아산병원 소아심장외과학교실)
  • Published : 2009.10.05
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Abstract

According to the 2007 International Society for Heart and Lung Transplantation (ISHLT) report, a congenital diagnosis, infantile transplantation and being on extracorporeal membrane oxygenation (ECMO) at the time of transplant are risk factors for mortality for the patients who undergo a heart transplant, and a large body weight ratio also increases the risk of mortality. The patient of this case underwent a Ross operation and mitral valve repair due to left ventricle outflow track obstruction and mitral regurgitation. But the baby was treated with ECMO due to heart failure after the operation. When he was 3-months-old and had been. on 30 days of ECMO, he underwent a heart transplant with a heart that had a high donor-recipient weight ratio (4.42). We present this case from a technical standpoint and we include a review of the relevant literature.

International Society for Heart and Lung Transplantation (ISHLT)는 2007년 보고에서 선천성 심질환, 1세 미만의 나이, 이식 당시 체외 막형 산소화 보조가 심장 이식 후 사망의 유의한 위험 요소임을 보고하였으며, 몸무게 차이가 클 경우에도 사망의 위험도를 높인다고 하였다. 이 증례의 환아는 심한 좌심실 유출로 협착, 승모판 폐쇄 부전이 있어 Ross수술과 승모판 성형술을 시행하였으나 술 후 심한 좌심실 기능부전으로 체외 막형 산소화 보조를 적용하였다. 체외 막형 산소화 보조 30일이 경과한 생후 3개월 경 공여자-수용자간 몸무게 비가 4.42에 이르는 매우 큰 심장을 성공적으로 이식하였기에 이식의 기술적인 주요 사항을 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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