保留主动脉瓣的根部替换术的研究进展  

Research Progress in Valve-sparing Aortic Root Replacement

作　　者：张帅[1] 钱向阳[1] ZHANG Shuai;QIAN Xiang-yang(Department of Cardiovascular Surgery,Fuwai Hospital//National Center for Cardiovascular Diseases//Chinese Academy of Medical Sciences//Peking Union Medical College,Beijing 100037,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//阜外医院血管外科中心,北京100037

出　　处：《中山大学学报（医学科学版）》2023年第5期741-749,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：中国医学科学院医学创新基金(2020-I2M-C&T-A-011);北京市科学技术委员会-首都临床诊疗技术研究及转化应用基金(Z201100005520003)。

摘　　要：随着外科技术的不断改进、医学工程学与材料学的发展,复合带瓣血管的根部置换术(Bentall手术)成为了主动脉根部病变的标准术式。作为Bentall手术的替代手段,保留主动脉瓣的根部替换术术后避免了终身抗凝和机械瓣膜的相关并发症,降低了血栓栓塞、出血事件的发生率,其有利的血流动力学和潜在更低的心内膜炎风险,保证了术后持久的主动脉瓣功能,患者的生存质量大大提高。本文综述了保留主动脉瓣的根部替换术的适应症、标准化技术要点及其在不同患者中应用的远期结果。With continuous improvements in surgical techniques,medical engineering and material science,root re⁃placement with composite valve graft(CVG)or Bentall procedure has become the standard procedure for aortic root le⁃sions.As an alternative to the Bentall procedure,valve-sparing aortic root replacement(VSRR)avoids the complications associated with lifelong anticoagulation and mechanical valves;reduces the incidence of thromboembolic and bleeding events;and its favorable haemodynamics and potentially lower risk of endocarditis ensure durable postoperative aortic valve function and a much better quality of patient survival.This article reviews the indications for root replacement with preservation of the aortic valve,the key points of the standardized technique and its long-term results in different patients.

关 键 词：保留主动脉瓣的根部替换术 主动脉瓣再植入 根部重塑 复合带瓣血管 进展 

分 类 号：R654.2[医药卫生—外科学]