Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Clinical features and results of recent neonatal cardiac surgery - A review of 82 cases in one hospital

최근 신생아 심장 수술의 특징과 결과 - 단일 병원에서의 82례 고찰

  • Oh, Ki Won (Department of Pediatrics and Thoracic, College of Medicine, Kyungpook National University) ;
  • Kim, Jung Ok (Department of Pediatrics and Thoracic, College of Medicine, Kyungpook National University) ;
  • Cho, Joon Yong (Department of Cardiovascular Surgery, College of Medicine, Kyungpook National University) ;
  • Hyun, Myung Chul (Department of Pediatrics and Thoracic, College of Medicine, Kyungpook National University) ;
  • Lee, Sang Bum (Department of Pediatrics and Thoracic, College of Medicine, Kyungpook National University)
  • 오기원 (경북대학교 의과대학 소아과학교실) ;
  • 김정옥 (경북대학교 의과대학 소아과학교실) ;
  • 조준용 (경북대학교 의과대학 흉부외과학교실) ;
  • 현명철 (경북대학교 의과대학 소아과학교실) ;
  • 이상범 (경북대학교 의과대학 소아과학교실)
  • Received : 2007.01.15
  • Accepted : 2007.06.08
  • Published : 2007.07.15
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Abstract

Purpose : The purpose of this study was to investigate the clinical features and outcome in newborns undergoing cardiac surgery. Methods : Eighty two neonates underwent heart surgery for congenital heart defect at Kyungpook National University Hospital between March 2000 and February 2006. Patient characteristics (sex, age, diagnosis), pre-operative conditions, operation type, postoperative complications and mortality were reviewed retrospectively. Results : In 82 patients, 41 (50%) were male. The mean age and weight at operation were 12 days and 3.2 kg, respectively. The common cardiac anomalies were complete transposition of the great arteries (TGA), Tetralogy of Fallot (TOF), pulmonary atresia with intact ventricular septum, and single ventricle variants. Fifty seven operations were performed with cardiopulmonary bypass and corrective surgery was done on 54 patients. Arterial switch operation and modified Blalock-Taussig shunt were most frequently performed as corrective and palliative operations, respectively. The early hospital mortality rate was 7%; the late mortality was 3.9%. Complications were acute renal insufficiency, delayed sternal closure, wound infection, arrhythmia, and brain hemorrhage. Conclusion : During the last 6 years, the outcomes of cardiac surgery for congenital heart defects in neonates improved by progress in perioperative, anaesthetic, surgical, and postoperative care.

목 적 : 최근 신생아기에 심장 수술을 받은 환아들의 임상적 특징 및 수술 성적에 대해 알아보고자 하였다. 방 법 : 2000년 3월부터 2006년 2월까지 6년간 경북대학교 병원에서 신생아기에 수술을 받은 82명에 대해 이들의 수술 당시 나이 및 체중, 심기형의 종류, 수술 전 상태, 수술 내용 및 결과, 합병증 등을 검토하였다. 결 과 : 대상 환아 82명 중 남아는 41명이었으며 수술 당시 평균 나이는 12일, 평균 몸무게는 3,200 g이었다. 주된 심기형은 완전대혈관전위, 활로씨사징, 심실중격이 온전한 폐동맥판폐쇄, 기능적 단심실이 다수를 차지하였다. 수술 방법으로 인공심폐기를 사용한 경우가 57례였고, 54례에서 완전 교정수술이 시행되었다. 수술 종류로 완전 교정수술로는 동맥전환수술이, 고식 수술로는 변형 B-T 단락술이 가장 많이 시행되었다. 총 사망은 9례(10.9%)였으며 이 중 조기 사망은 6례, 만기 사망은 3례였다. 수술 후 합병증은 급성 신기능 부전, 지연 흉골 봉합, 상처감염, 수술 후 부정맥, 뇌실내 또는 뇌내출혈 등이 발생하여 내과적 치료를 필요로 하였다. 결 론 : 최근 6년간 본원에서 신생아기의 선천성 심장병에 대한 수술적 치료는 수술 전 처치, 수술 방법, 체외 순환법 그리고 수술 후 집중 치료의 발달을 통해서 많은 향상을 보였다.

Keywords

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