Cotrufo Maurizio, Agozzino Lucio, De Feo Marisa, Della Corte Alessandro, De Santo Luca S, Di Benedetto Giuseppe, Esposito Salvatore, Nappi Gianantonio
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples, Italy.
Ital Heart J. 2003 Sep;4(9):589-95.
Several pathogenetic mechanisms account for the association of the ascending aorta dilation with aortic valve dysfunction. Functional aortic insufficiency can derive from medial degeneration of the aortic wall and annuloaortic ectasia; leaflet structural disease can determine root dilation by increasing aortic wall stress in case of both regurgitation and stenosis; aortic valve disease and aortic aneurysm can however coexist due to two different intrinsic etiologies. In the attempt to best tailor the surgical correction of such conditions to the underlying causative mechanism, several technical options have already been developed including composite or separate aortic valve and root replacement, valve-sparing operations, and aortoplasty techniques. The criteria for surgical indication cannot leave the underlying pathogenesis out of consideration as well. The newly acquired knowledge in the basic research on this topic is expected to affect the approach to the individual patient in the future.
几种发病机制解释了升主动脉扩张与主动脉瓣功能障碍之间的关联。功能性主动脉瓣关闭不全可源于主动脉壁的中层变性和主动脉瓣环扩张；在反流和狭窄的情况下，瓣叶结构疾病可通过增加主动脉壁应力来导致根部扩张；然而，主动脉瓣疾病和主动脉瘤可能由于两种不同的内在病因同时存在。为了根据潜在的致病机制更好地调整对此类病症的手术矫正方法，已经开发了几种技术选择，包括复合或单独的主动脉瓣和根部置换、保留瓣膜的手术以及主动脉成形术技术。手术适应症的标准也不能不考虑潜在的发病机制。预计该主题基础研究中获得的新知识将在未来影响对个体患者的治疗方法。
