Journal of Chest Surgery

  • 제29권12호
  • /
  • Pages.1337-1341
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  • 1996
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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인공판막혈전증에 대한 외과적 치료

Surgical Treatment of Prosthetic Valve Thrombosis

  • 유영선 (계명대학교 의과대학 흉부외과학교실) ;
  • 최세영 (계명대학교 의과대학 흉부외과학교실)
  • 발행 : 1996.12.01
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초록

계명대학교 의과대학 흉부외과학교실에서는 1989년 9월부터 1996년 3월까지 13명의 판막혈전증환자에서 16례의 재수술을 시행하였다. 연령분포는 32세부터 63세까지로 평균연령은 45.2세였으며 남여비는 1:2.3이었다. 판막치 환술후 재수술까지 걸린 기간은 평균 27.8개월이었으며 입원후 수술시까지 걸린 시간은 평균 33.5시간이 있다. 술전 UYHA 기능분류 4도가 12례(75%)였으며 이중 6례가 쇽상태 였다. 재수술은 판막치 환술이 15례, 혈전제거술만 시행한 경우가 1례있었다. 수술사망은 4례(25%)였으며 사망원인은 패혈증이 2례. 저심박출증이 2례였다. 술후 평균 30.3개월 추적조사하였고 술후 UYHA기능분류는 평균 1.2로 양호하였으며 만기 사망례는 없었다. 판막혈전증에 대한 재수술요법은 조기 진단하여 환자상태가 비교적 안정적일때 수술하는 것이 수술사망을 줄이는 방법으로 사료된다.

From September 1989 to March 1996, 13 patients with prosthetic valve thrombosis underwent reoperdtion on 16 occasions. The mean interval between implantation and reoperation was 27.8 months. The anticoagulation status was inadequate in 44% of th Instances. The majority(75%) were in NYHA functional class IV, 6 of them being in shock. Reoperation was performed for valve replacement(15 of 16 occasions) or thrombectomy(1 of 16 occasions) within 3 to 192 hours(mean 33.5 hours). Operative mortality at reoperation was 25%(4 patients). Re-thrombosis occurred In 3 patients. Long-term outcome was satisfactory in all survivors with a mean follow-up of 30.B months. The present results indicate that an early diagnosis and prompt surgical intervention is needed to decrease operative mortality.

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참고문헌

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