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首页> 外文期刊>Journal of cardiac surgery. >Concomitant replacement of the dilated ascending aorta during aortic valve replacement; Does it increase the perioperative morbidity and mortality risks?
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Concomitant replacement of the dilated ascending aorta during aortic valve replacement; Does it increase the perioperative morbidity and mortality risks?

机译：主动脉瓣置换过程中同时伴有扩张的升主动脉置换;它会增加围手术期的发病率和死亡率风险吗？

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Background: Concerns of increased surgical risks with ascending aortic replacement have led surgeons to manage post-stenotic aortic dilatation more conservatively during aortic valve replacement (AVR). The present study aimed to assess the prognostic implications and surgical risks of replacing the dilated aorta during AVR. Methods: Between January 1999 and March 2010, 134 patients who received surgery for aortic stenosis and post-stenotic dilatation (aorta size ≥40 mm) were included in the present study. AVR was performed in 92 patients (AVR group) while aortic valve and ascending aorta replacement (AVR + aorta group) were performed in 42 patients. Overall survival was compared between the two groups using Cox proportional hazard model after adjustment with inverse-probability-of-treatment weighting. Results: The mean follow-up duration was 3.5 ± 3 years. There were no significant differences in the operative mortality and morbidity between the two groups. The late cardiac deaths were also not significantly different between the two groups (p = 1.00). In the AVR group, the ascending aortic expansion rate which was 0.18 mm/year over a mean follow-up duration of 2.3 ± 2.2 years by echocardiography showed a positive correlation with time (r = 0.3, p = 0.08). A relatively greater aortic expansion rate was identified as a risk factor for late mortality (p = 0.015, HR 1.08 (CI: 1.02 to 1.15). Conclusions: Concomitant replacement of the dilated ascending aorta during AVR did not increase the immediate postoperative morbidity or mortality risks and tended to exert a long-term beneficial effect on the risk of late mortality.
机译：背景：随着主动脉置换的增加，外科手术风险增加的担忧已导致外科医生在主动脉瓣置换（AVR）期间更加保守地处理狭窄后主动脉扩张。本研究旨在评估AVR期间置换扩张主动脉的预后影响和手术风险。方法：1999年1月至2010年3月，本研究纳入134例因主动脉瓣狭窄和狭窄后扩张（主动脉大小≥40 mm）而接受手术的患者。 92例患者（AVR组）进行了AVR，而42例患者进行了主动脉瓣和升主动脉置换（AVR +主动脉组）。在用治疗可能性反比加权进行调整后，使用Cox比例风险模型比较两组的总生存率。结果：平均随访时间为3.5±3年。两组的手术死亡率和发病率无显着差异。两组之间的晚期心源性死亡也无显着差异（p = 1.00）。在AVR组中，超声心动图平均随访时间为2.3±2.2年，主动脉扩张速率为0.18 mm /年，与时间呈正相关（r = 0.3，p = 0.08）。较高的主动脉扩张率被认为是晚期死亡的危险因素（p = 0.015，HR 1.08（CI：1.02至1.15）。结论：在AVR期间同时置换扩张的升主动脉不会增加术后立即的发病率或死亡率。风险，并且倾向于对晚期死亡的风险产生长期的有益影响。

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