Abstract
With the introduction of new cardiac prosthesis, it behooves surgeons and cardiologists to monitor its performance carefully. ATS (Advancing The Standard) prosthetic valve has been used first in Guro hospital in Korea, since August 1994. Between August 1994 and July 1995, 21 patients received 28 ATS prosthesis(9 aortic, 19 mitral).19mi1ra1 valves were implanted through the "Extended Transseptal Approach" 10 were ma e and 11 were female, ranging from 20 to 54 years of age(Mean age : 37 years). The follow up period 126 patient-months(mean 6.1 months), varied from 1 month to 12 months. NYHA functional class was improved significantly, from $2.9\pm0.7$ preoperatively to $1.4\pm0.5$ postoperatively. Ejection fraction was also improved from $55.5\pm6.1%$ preoperatively to 59.8 $\pm7.4%$ postoperatively. Lactic dehydrogenase(LDH) was used as an indicator of hemolysis. The value of LDH changed from 483.3 $\pm$ 162 lUlL preoperatively to $527\pm274$ lUff postoperatively with no clinical significailce. Valve related complications, such as thromboembolism, valve thrombosis, anticoagulant related hemorrhage and prosthetic valve endocarditis did not develop except one anticoagulant related intracranial hemorrhage. There were no mortalities. This experience encourages us to continue using the ATS prosthetic valve, and this study will help those patients who need to have their heart valves replaced. replaced.
고려대학교 구로병원에서는 1994년 8월부터 국내에서는 처음으로 새로운 이엽성 기계판막인 ATS(Advancing The Standard)을 이용, 21명의 환자에게 28개의 판막을 치환하였다. 환자는 평균연령 27세로 10명의 남자와 11명의 여자로 수술전후의 NYHA 기능적분류는 평균 2.9에서 1.4로 감소하였다. 심초음파상의 심박출 지수는 55.5에서 59.8으로 다소 상승하였다. 치환후 승모판 전후의 압력차는 양호하였으며,용혈 여부를 확인하기위한 LDH치는 다소 상승하였으나 임상적 중요성은 없었다. 판막과 관련된 합병증은 없었으며, 항응고제 투여와 관련된 뇌출혈이 1례 있었다. 사망례는 없었으며, 현재는 모든 환자에