主动脉瓣成形术于A型主动脉夹层治疗中的应用  

Aortic valvuloplasty in the surgical therapy of type A aortic dissection

作　　者：冯永滔[1,2] 范瑞新 马少鸿[1,2] 范小平[1,2] 

机构地区：[1]广东省医学科学院 广东省人民医院 [2]广东省心血管病研究所心外科,广州510080

出　　处：《岭南心血管病杂志》2012年第3期266-268,302,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省科技计划项目(项目编号:2007B031515007)

摘　　要：目的总结采用主动脉瓣成形术治疗主动脉夹层撕裂引起的主动脉瓣反流(aortic regurgitation,AR)的经验及术后随访分析。方法分析2007年3月至2011年9月广东省人民医院收住的100例因主动脉夹层引起的AR,采用主动脉瓣成形术处理纠正AR的患者的资料,并对术后患者进行门诊随访,了解术后病情变化。所有患者病因均排除马凡氏综合征。结果住院死亡5例。随访(110±39)周,术后1周、3个月及9个月患者AR面积、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDd)、左心室收缩末期内径(left ventricularend-systolic dimension,LVESd]、左心室射血分数(left ventricular ejection fraction,LVEF)均较术前有明显改善,差异有统计学意义(P<0.05)。术后1周、3个月及9个月后患者AR面积、LVEDd、LVESd及LVEF两两比较,差异无统计学意义(P>0.05)。1例患者术后2年因AR加重而再次返院行主动脉瓣置换术,余患者门诊随访效果良好。结论主动脉瓣成形术是治疗主动脉夹层撕裂引起的AR有效的手术方法,且效果稳定。Objectives To summarize the experience and the follow-up analysis of aortic valvuloplasty in the surgical treatment of aortic regurgitation （AR） induced by Stanford type A aortic dissection. Methods One hundred patients with Stanford type A aortic dissection complicated with AR underwent surgical treatment with aortic valvuloplasty from March 2007 to September 2011 in Guangdong General Hospital were included in this study. The patients were analyzed and followed up after surgery. All the patients were not diagnosed Marfan syndrome. Results There were 5 deaths during in hospital. During a follow-up of （110±39） weeks, AR, left ventricular end diastolic dimension （LVEDd）, left ventricular end-systolic dimension （LVESd） and left ventricular ejection fraction （LVEF） of the patients in l week, 3 months and 9 months after surgery were significantly improved （P〈0.05）. AR, LVEDd, LVESd and LVEF of the patients in 1 week, 3 months and 9 months after surgery had no obvious differences when compared with each other（P〉 0.05）. One patient went back to hosipital for re-operation because of severe AR after two years. Others reported in good conditions. Conclusions Aortic valvuloplasty has a good therapeutic effect on type A aortic dissection with AR.

关 键 词：主动脉夹层 主动脉瓣反流 主动脉瓣成形术 主动脉置换 

分 类 号：R543.16[医药卫生—心血管疾病]