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KMID : 0367219920090020201
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Sejong Medical Journal
1992 Volume.9 No. 2 p.201 ~ p.208
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One Stage Total Correction of the Complex Heart Disease with the Aortic Arch
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한재진
박표원/이영탁/박영관/이영균/노준량
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Abstract
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There is still controvercy between one stage total correction versus staged correction for the patients of coarctation (COA) or interrupted aortic arch (IAA) with other intracardiac anomalies.
26 patients of COA/IAA with VSD or other complex heart disease were received one stage total corrective sugeries from March 1987 to February 1992 at Sejong General Hospital. There were 12 males and 14 females. And their ages were from 20 days to
7
years
old (mean : 7.8±15.6 months old).
From the viewpoint of aortic arch anomaly. COA cases were 20 and IAA were 6. And from the main intracardiac anomaly. VSD/ASD±Left ventricular outflow tract obstruction (LVOTO) were 18. Taussing-Bing anomaly 2. Truncus arteriosus 2.
Aorticopulmonary
window 1. Transposition of great arteries 1, Double outlet of right ventricle 1. and complete atrioventricular septal defect was one case.
We used deep hypothermic or total circulatory arrest technique, and aortic recontructive methods were ; 16 resection and end to end anastomosis, 7 on-lay patch with bovine pericardium and 3 others, and associated intracardiac proccdures were : 15
VSD
closure, 8 LVOTO relief, 2 intracardiac baffling, 2 arterial switch operation, 1 REV, 1 Rastelli operation, and so on.
The operative mortalities were 7 cases (27%) and late mortalities were 2 cases. Among the 15 cases of COA/IAA+simple defects, there was only one death. We concluded that the one stage total correction of congenital cardiac disease with aortic
arch
anomaly was reasonable method and especially, safe, efficient and economical for the patients associated with simple intracardiac defects. We also expect the patients associated complex heart disease to be better results gradually with the
improvement
of the total correction for those complex anomalies.
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KEYWORD
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