斜切口楔形切除法升主动脉成形术临床效果的单中心回顾性研究  

Clinical efficacy of reduction ascending aortoplasty with wedge resection in adult patients undergoing aortic valve replacement:A single-center retrospective study

作　　者：周晓辉[1] 关强 刘睿[1] 孙寒松[1] 冯钧[1] 王立清[1] ZHOU Xiaohui;GUAN Qiang;LIU Rui;SUN Hansong;FENG Jun;WANG Liqing(Department of Adult Surgery,National Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院成人外科中心,北京100037

出　　处：《中国胸心血管外科临床杂志》2022年第12期1631-1636,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析斜切口楔形切除法升主动脉成形术在成人主动脉瓣病变伴升主动脉扩张患者中的临床效果。方法回顾性分析2010—2019年阜外医院同期行主动脉瓣置换术+升主动脉成形术30例患者的临床资料,其中男20例、女10例,年龄38~72(55.73±9.95)岁。采用超声心动图或心脏主动脉CT分别测量术前、术后及末次随访时的升主动脉直径,比较斜切口楔形切除法升主动脉成形术后的升主动脉直径变化情况。结果本组30例患者无围手术期死亡。术前升主动脉直径为(48.23±3.69)mm,术后出院前为(37.60±5.02)mm,末次随访时为(40.53±4.65)mm;术前与术后、术后与末次随访时、术前与末次随访时升主动脉直径差异具有统计学意义。全部患者术后中位随访时间28.50(12~114)个月。全组术后升主动脉直径中位增长率为0.76 mm/年。有5例患者增长率超过3 mm/年,随访时间全部为术后12~15个月,其中早期手术的4例(4/30,13.3%)患者术后增长率接近或者超过5 mm/年,具备再次手术指征。结论斜切口楔形切除法升主动脉成形术能有效缩短升主动脉直径,中期随访结果良好,但仍有部分患者需再次外科干预治疗。Objective To assess mid-term outcomes of reduction ascending aortoplasty(RAA)in adult patients undergoing aortic valve replacement(AVR).Methods We retrospecctively analyzed clinical data of 30 adult patients with aortic valve diseases and ascending aortic dilatation in Fuwai Hospital from 2010 to 2019.There were 20 males and 10 females with an age of 38-72(55.73±9.95)years.All patients received AVR+RAA using the wedge resection technique.Ascending aorta diameter(AAD)was measured by echocardiography or CT scan preoperatively and postoperatively.Results There was no perioperative death.The mean preoperative and postoperative AAD in all patients were 48.23±3.69 mm and 37.60±5.02 mm,respectively.And the mean AAD of follow-up was 40.53±4.65 mm.There was a statistical difference in AAD between preoperation and postoperation,postoperation and final follow-up,preoperation and final follow-up.The median follow-up time was 28.50(12-114)months.The median rate of increase in AAD postoperatively was 0.76 mm per year.And the rate of increase was≥3 mm per year in 5 patients,while≥5 mm per year in 4 patients with indications for reoperation.Conclusion Mid-term outcomes of RAA in adult patients undergoing aortic valve replacement using the wedge resection technique are satisfying and encouraging.However,some patients still need surgical re-intervention.

关 键 词：主动脉瓣置换术 升主动脉成形术 升主动脉扩张 楔形切除法 

分 类 号：R654.2[医药卫生—外科学]