새로운 대동맥판 성형술

배경 및 목적：이 연구의 목적은 새로이 개발된 대동맥판 성형술의 결과를 알아보기 위한 것이다.방 법：대동맥 근부의 세가지 중요한 요소인 판막륜, 동관연결부,판막엽의 교정에 중점을 둔 새로운 대동맥판 성형술이 1997년 12월부터 2005년 4월까지 75명의 환자에서 시행되었다.이는 ring과 strip을 이용해 대동맥 판막륜과 동관연결부의직경을 줄이고 주로 판막엽 첨가술을 이용하여 비정상적인 판막엽을 교정하는 술식으로 구성되어 있다. 병리학적 소견에따라 순수 대동맥판 폐쇄부전증 35명, 상행대동맥류에 의한대동맥판 폐쇄부전증 22명, 그리고 대동맥 근부확장증에 의한 대동맥판 폐쇄부전증 18명이 있었다. Background and Objectives：The purpose of this study was to assess the results of a newly developed aortic valverepair technique. Subjects and Methods：Between December 1997 and April 2005, 75 aortic valvuloplasties wereperformed using a new technique that addressed the 3 main components of the aortic root; annulus, sinotubularjunction and leaflet. An internal synthetic strip and ring were implanted along the fibrous annulus to reduce theannulus and sinotubular junction, and additional leaflets were implanted for leaflet correction. Based on theprimary pathology, there were 35, 22 and 18 cases of isolated aortic regurgitation, aortic regurgitation due toascending aortic aneurysm and aortic regurgitation due to annuloaortic ectasia, respectively. Results：The averageage of the subjects was 46.4±16 years; there were 51 and 24 males and females, respectively. There was no operativemortality, with a 2-year freedom from reoperation rate of 97%. Follow up echocardiograms showed significantimprovements in the grade of aortic regurgitation, from a preoperative mean of 3.1±1.2 to 1.08±0.7 immediatepostoperatively, to 1.15±0.6 at the final follow up. Conclusion：The results of the current study showed thistechnique to be effective in the treatment of aortic regurgitation of various causes. Although long-term results arepending, it is our contention that this aortic valve repair technique will be a reliable method in the future.(Korean Circulation J 2006;36:140-149) KCI Citation Count: 1