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首页> 外文期刊>Circulation journal >Reduction aortoplasty for the ascending aortic aneurysm with aortic valve disease. Does bicuspid valve matter?
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Reduction aortoplasty for the ascending aortic aneurysm with aortic valve disease. Does bicuspid valve matter?

机译：升主动脉瘤合并主动脉瓣病变的还原性主动脉成形术。二尖瓣重要吗？

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BACKGROUND: The outcomes of reduction ascending aortoplasty (RAA) performed with aortic valve surgery were evaluated and the results of RAA in patients with bicuspid aortic valve (BAV) were compared with those in patients with tricuspid valve. METHODS AND RESULTS: From October 1994 to April 2009, 88 patients underwent RAA. Aortic valve was bicuspid in 45 patients (BAV group) and tricuspid in 43 patients (TAV group). Total circulatory arrest was required in 45 patients. Preoperative ascending aortic diameter was 45.5+/-4.7mm. Early mortality rate was 1.1%. Ten-year survival rate and freedom from cardiac death were 91.1% and 96.2%, respectively. No differences in clinical outcomes were found between the 2 groups. No aorta-related complications including aortic rupture, dissection and reoperation were observed. Aortic diameter at the last follow-up (61+/-43 months) was 37.8+/-4.3mm. The interval between surgery and follow-up CTA was associated with aneurysmal recurrence (P=0.022). Average rate of dilatation was 0.42+/-0.49mm/year (n=37). A need for total circulatory arrest was associated with an increase of the aortic diameter (P=0.009). BAV was associated with neither aneurysmal recurrence nor increase of aortic diameter. CONCLUSIONS: RAA in patients with an ascending aortic aneurysm combined with aortic valve disease could be performed with acceptable early and long-term outcomes, even in patients with BAV. Long-term follow-up evaluation might be necessary due to the risk of redilatation especially in patients with an extended aneurysm, which required total circulatory arrest for RAA.
机译：背景：评估主动脉瓣手术进行的升主动脉成形术（RAA）的结果，并比较三尖瓣主动脉瓣（BAV）患者和三尖瓣主动脉瓣患者的RAA结果。方法和结果：从1994年10月到2009年4月，有88例患者接受了RAA。主动脉瓣是二尖瓣的45例（BAV组）和三尖瓣43例（TAV组）。 45例患者需要全部循环止搏。术前升主动脉直径为45.5 +/- 4.7mm。早期死亡率为1.1％。十年生存率和免于心脏死亡的比率分别为91.1％和96.2％。两组之间的临床结局无差异。没有观察到与主动脉相关的并发症，包括主动脉破裂，解剖和再次手术。最后一次随访（61 +/- 43个月）的主动脉直径为37.8 +/- 4.3mm。手术和随访CTA之间的间隔与动脉瘤复发有关（P = 0.022）。平均扩张率为0.42 +/- 0.49mm /年（n = 37）。全循环停搏的需要与主动脉直径的增加有关（P = 0.009）。 BAV与动脉瘤复发或主动脉直径增大均无关。结论：升主动脉瘤合并主动脉瓣疾病的患者即使在BAV患者中，RAA的早期和长期结果也可以接受。由于存在再发的风险，因此可能需要长期的随访评估，尤其是对于动脉瘤延长的患者，这需要对RAA进行全面的循环性停搏。

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