Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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The Results of using the Cabrol Technique for Aortic Root Replacement

대동맥 근부치환술에 대한 Cabrol 술식의 성적

  • Kim, Jeong-Won (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Lee, Jong-Tae (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Cho, Joon-Yong (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Kim, Kyu-Tae (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Kim, Gun-Jik (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine)
  • 김정원 (경북대학교 의과대학 경북대학교병원 흉부외과학교실) ;
  • 이종태 (경북대학교 의과대학 경북대학교병원 흉부외과학교실) ;
  • 조준용 (경북대학교 의과대학 경북대학교병원 흉부외과학교실) ;
  • 김규태 (경북대학교 의과대학 경북대학교병원 흉부외과학교실) ;
  • 김근직 (경북대학교 의과대학 경북대학교병원 흉부외과학교실)
  • Published : 2008.10.05
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Abstract

Background: Composite valve graft replacement is currently the treatment of choice for a wide variety of the lesions of aortic root disease. The purpose of this study was to explore the results of aortic root replacement after using the Cabrol technique over a 13-year period at our institution, and we analyzed the results to help surgeons make better decisions when repairing aortic root disease. Material and Method: Between January 1994 and December 2006, twenty-five patients underwent a Cabrol technique operation at our institution. The mean patient age was $43.7{\pm}14.1$ years old (range: $6{\sim}65$ years) and the male and female ratio was 21:4 (84% : 16%). The patients' follow-up was 100% complete, and the mean follow-up period was $60.7{\pm}50.4$ (range:$1{\sim}162$) months. Annuloaortic ectasia (n=18) was the most frequent cause of aortic disease in this series, followed by aortic dissection (n=7). The mean cardiopulmonary bypass time was $177.2{\pm}44.9$ minutes and the mean aortic cross clamping time was $123.4{\pm}34.1$ minutes. Nine patients were checked with MDCT (Multidetector computed tomography) for evaluating a well functioning secondary graft and the coronary anastomosis site. Result: The early mortality rate was 4% (1 of 25 patients). A significant stenosis, kinking or occlusion of the secondary graft was detected by MDCT in 4 patients. The overall survival rate was 88%. Conclusion: The Cabrol technique demonstrated a significant incidence of long-term complications such as secondary graft stenosis or obstruction. It could be used when the modified Bentall technique is not feasible.

배경: 대동맥근부의 여러 질환에 있어서 인공판막도관을 이용한 대동맥근부 치환술은 현재 가장 보편적으로 사용되고 있으며, 여러 가지 변형 방법이 소개되고 있다. 그 중 13년간 Cabrol 술식을 이용하여 본원에서 대동맥근부 치환술을 시행하였던 환자들을 대상으로 수술 결과를 분석, 평가하였다. 대상 및 방법: 1994년 1월부터 2006년 12월까지 본원에서 Cabrol 술식을 적용한 25예를 조사 대상으로 하였다. 환자들의 평균연령은 $43.7{\pm}14.1$세(6세${\sim}$65세)였으며 성별은 남자 21명, 여자는 4명이었다. 생존한 모든 환자에서 추적관찰이 이루어졌으며, 평균추적관찰기관은 $60.7{\pm}50.4\;(1{\sim}162)$개월이었다. 수술 전 진단은 대동맥판막 폐쇄부전을 동반한 대동맥판륜확장증이 18예로 가장 많았으며, 대동맥판륜확장을 동반한 대동맥박리가 7예 있었다. 결과: 수술사망은 1예(4.0%)가 있었으며 MDCT를 촬영한 9예 중 4예에서 관상동맥문합부의 의미 있는 협착 및 폐색이 확인되었다. 결론: Cabrol 술식은 비록 낮은 수술사망률을 보이나, 관상동맥문합부의 협착 및 폐색 등의 장기 합병증에 대해서는 다소 높은 이완률이 확인되었으며 이에 따라 Cabrol 술식의 적용은 대동맥근부에 대한 재수술 및 대동맥판륜과 관상동맥 입구부가 매우 가까운 경우 등 제한적인 경우에 사용하는 것이 바람직하다고 판단된다.

Keywords

References

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