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首页> 外文期刊>European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery >Aortic root stability in bicuspid aortic valve disease: patch augmentation plus reduction aortoplasty versus modified David type repair.
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Aortic root stability in bicuspid aortic valve disease: patch augmentation plus reduction aortoplasty versus modified David type repair.

机译：二尖瓣主动脉瓣疾病的主动脉根部稳定性：修补术加减主动脉成形术与改良型David型修复术。

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OBJECTIVES: The unreinforced aortic root, in bicuspid aortic valve disease, has been shown to dilate and cause recurrent regurgitation. The objective of this study was to determine whether reduction aortoplasty can reliably prevent aortic root dilatation after aortic valve repair in bicuspid disease. METHODS: A total of 66 patients, with a mean age of 41.2+/-12 years and with incompetent bicuspid aortic valves and concomitant dilatation of the aortic root, were included in this study. As many as 49 patients had patch augmentation of the free edge of the bicuspid aortic leaflets and reduction aortoplasty, and a further 17 patients had patch augmentation and a modified David type repair. Patients were followed up by echocardiography and clinically in yearly intervals. RESULTS: At midterm (mean follow-up was 5.1 +/- 2.1 years), only one patient in the reduction aortoplasty group showed aortic root dilatation, leading to significant aortic valve regurgitation. Other than that, there was no progression of regurgitation in the whole group of patients. In the David type repair group, no re-operations, progression of aortic root dilatation or recurrent regurgitation occurred. In general, there was only one death in the reduction aortoplasty group. This patient developed endocarditis after 1 year and died of acute heart failure prior to readmission to our hospital. CONCLUSION: Both reduction aortoplasty and modified David type repair, paired with patch augmentation of the incompetent bicuspid valve, provide excellent midterm results. The reduction of the diameter of the ascending aorta by reduction aortoplasty seems to provide reliable stability that is comparable to the David type repair.
机译：目的：在二尖瓣主动脉瓣疾病中，未增强的主动脉根部已显示扩张并引起复发性返流。这项研究的目的是确定在二尖瓣疾病的主动脉瓣修复后，降主动脉成形术是否能够可靠地预防主动脉根部扩张。方法：本研究共纳入66例患者，平均年龄41.2 +/- 12岁，双主动脉瓣功能不全，主动脉根部同时扩张。多达49例患者出现了二尖瓣主动脉小叶自由边缘的斑块增大和主动脉成形术减少，另外17例患者出现了斑块增大和改良的David型修复。对患者进行超声心动图检查，并在临床上每年进行一次随访。结果：在中期（平均随访时间为5.1 +/- 2.1年），降主动脉成形术组中只有1例患者出现主动脉根部扩张，导致主动脉瓣反流明显。除此之外，整个患者组都没有反流的进展。在David型修复组中，未发生再次手术，主动脉根部扩张或复发性反流。通常，在还原性主动脉成形术组中只有1例死亡。该患者在1年后患上心内膜炎，死于急性心力衰竭，然后再次入院。结论：减少主动脉成形术和改良的David型修复，再加上功能不全的二尖瓣膜修补术，均能提供出色的中期效果。通过减少主动脉成形术来减小升主动脉的直径似乎提供了与大卫型修复术相当的可靠稳定性。

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