保留瓣膜的主动脉根部置换术治疗法洛四联症术后主动脉根部扩张的临床疗效  

Clinical effectiveness of valve-sparing aortic root replacement in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot

作　　者：李希[1] 谭今[1] 黄克力[1] 于涛[1] 蒋露[1] LI Xi;TAN Jin;HUANG Keli;YU Tao;JIANG Lu(Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu,610072,P.R.China)

机构地区：[1]四川省医学科学院·四川省人民医院,成都610072

出　　处：《中国胸心血管外科临床杂志》2024年第1期122-126,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评价保留瓣膜的主动脉根部置换术(valve-sparing aortic root replacement,VSARR)治疗法洛四联症术后主动脉根部扩张的临床效果。方法回顾性分析2016—2022年四川省人民医院采用VSARR治疗法洛四联症术后合并主动脉根部扩张患者的临床资料。结果共纳入14例患者,其中男8例、女6例,中位年龄22(12~48)岁。主动脉瓣重度反流5例、中度反流4例、轻度及以下反流5例。主动脉窦部扩张6例,升主动脉明显扩张8例,同期合并室间隔缺损残余分流1例,合并重度肺动脉瓣反流9例。VSARR方式为David手术10例,Yacoub手术2例,Florida sleeve 2例。全组无手术死亡。术后患者中位随访时间2.9(0.4~6.0)年,1例患者出现轻度主动脉瓣反流,其余患者均为微量或无主动脉瓣反流,1例患者出现左室流出道轻度狭窄,余所有患者左室流出道未见明显狭窄。结论VSARR在法洛四联症术后主动脉根部扩张患者中治疗结果满意,中期随访未见明显左室流出道狭窄,主动脉瓣反流发生率无明显上升。Objective To evaluate the clinical effectiveness of valve-sparing aortic root replacement(VSARR)in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot(TOF).Methods A retrospective analysis was conducted on clinical data of TOF patients with aortic root dilation who underwent VSARR in our hospital from 2016 to 2022.Results Finally 14 patients were collected,including 8 males and 6 females,with a median age of 22 years ranging from 12-48 years.Among them,5 patients had severe aortic valve regurgitation,4 moderate regurgitation,and 5 mild or no regurgitation.Six patients had sinus of valsalva dilation,and 8 significant dilation of the ascending aorta.One patient had residual shunt due to ventricular septal defect,and 9 severe pulmonary valve regurgitation.The David procedure was performed in 10 patients,Yacoub procedure in 2 patients,and Florida sleeve in 2 patients.There was no perioperative mortality in the group.The median follow-up time was 2.9 years(ranging from 0.4 to 6.0 years).One patient had mild aortic valve regurgitation,and the rest had minimal or no regurgitation.One patient had mild stenosis of the left ventricular outflow tract,and the rest patients had no obvious stenosis.Conclusion VSARR is a satisfactory treatment for aortic root dilation in patients with TOF,with no significant increase in the incidence of left ventricular outflow tract stenosis or aortic regurgitation during mid-term follow-up.

关 键 词：保留瓣膜的主动脉根部置换术 法洛四联症 主动脉根部扩张 

分 类 号：R654.2[医药卫生—外科学]