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首页> 外文期刊>Journal of cardiac surgery. >Aortic valve repair and root preservation by remodeling, reimplantation, and tailoring: technical aspects and early otcome.
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Aortic valve repair and root preservation by remodeling, reimplantation, and tailoring: technical aspects and early otcome.

机译：通过重塑，再植入和定制来修复和修复主动脉瓣：技术方面和早期发现。

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Objectives: Evaluate aortic root preserving/sparing procedures for various pathologies associated with ascending aortic aneurysms, including aortic valve regurgitation. Methods: From the end of 1990 through end of 2004, 388 patients had aortic root preserving procedures (reimplantation 72, remodeling 77, tailoring 239) +/- leaflet repair. Preoperatively, in-house grade aortic regurgitation was 1(+) in 58, 2(+) in 110, 3(+) in 101, and 4(+) in 66. Concurrent leaflet repairs were done in 197 (50.8%, Cabrol/Trusler commissure stitch 158, leaflet plication 36, supracommissure stitch 42, leaflet resection and repair 16, perforation repair 18, and debridement 11). Additional procedures included arch repair in 227 (58%), coronary bypass in 83 (21.4%), elephant trunk in 33 (8.5%), and minimally invasive approach in 30 (7.7%). Pathologies included dissection in 140 (36%; 86 acute), Marfan syndrome in 39 (10%), bicuspid valve in 78 (20%), and degenerative aneurysm in 142 (36.6%). The CLASS (Commissure, Leaflet, Annulus, Sinuses, Sinotubular) evaluation schema is described that is used for selecting either reimplantation, remodeling, or tailoring of the aortic root according to underlying pathology. Results: Hospital survival was 97.4% (378/388) and stroke occurred in 4.6% (18/388, four permanent, [1%]). On postoperative echocardiography, patients had either no (0) or 1(+) regurgitation (1(+)= 98);13 (3.4%) had 2(+). Three patients (1%) required reoperation for aortic valve failure before discharge (two tailoring, one remodeling). Conclusions: Excellent early results can be achieved by aortic root preserving procedures and concurrent aortic valve leaflet repairs when appropriately selected for a diverse class of pathologies.
机译：目的：评估与升主动脉瘤相关的各种病理的主动脉根部保留/保留程序，包括主动脉瓣返流。方法：自1990年底至2004年底，有388例患者进行了主动脉根部保留术（再植72例，改建77例，定制239例）+/-瓣膜修复。术前，室内等级的主动脉瓣反流在58中为1（+），在110中为2（+），在101中为3（+），在66中为4（+）。同时进行的小叶修复术为197（50.8％，Cabrol） / Trusler合缝针158，小叶折痕36，超合缝针42，小叶切除和修补16，穿孔修补18和清创术11）。其他手术包括227例（58％）的牙弓修复术，83例（21.4％）的冠状动脉搭桥术，33例（8.5％）的象鼻躯干和30例（7.7％）的微创手术。病理包括解剖140例（36％; 86例急性），马凡氏综合征39例（10％），双尖瓣膜78例（20％）和退行性动脉瘤142例（36.6％）。描述了CLASS（Commissure，Leaflet，Annulus，Sinuses，Sintubular）评估方案，该方案用于根据基础病理学选择再植入，重塑或定制主动脉根。结果：医院存活率为97.4％（378/388），中风发生率为4.6％（18/388，四个永久患者，[1％]）。在术后超声心动图检查中，患者无（0）或1（+）反流（1（+）= 98）; 13（3.4％）有2（+）。三名患者（1％）因出院前主动脉瓣衰竭而需要再次手术（两次剪裁，一次塑形）。结论：当针对多种病理类型进行适当选择时，主动脉根部保留术和同时进行的主动脉瓣小叶修复可以取得出色的早期结果。

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