Yoshida K, Tobe S, Kawata M, Yamaguchi M
Department of Cardiovascular Surgery, Akashi Medical Center, Japan.
Kyobu Geka. 2006 Apr;59(4):324-8.
From March 2002 to August 2005, 53 patients with age between 30 and 86 underwent surgical treatment for aortic valve disease. Preoperative diastolic heart failure was observed in 15 cases (28.3%). Operative procedures consisted of aortic valve replacement (AVR) in 42 cases [AVR and mitral valve replacement (MVR) in 3], aortic valve plasty (AVP) in 2, and aortic root replacement in 4. Concomitant procedures included maze procedure in 2 cases, coronary artery bypass grafting (CABG) in 6, mitral valve surgery in 15, and tricuspid valve annuloplasty (TAP) in 8. There were 7 cases for patient-prosthesis mismatch (PPM) [13.2%]. There were 2 hospital deaths (both were low-output syndrome). Among the surgical survivors, there were 2 late cardiac-related complications (all cases were cardiac failure). There was no recurrence or re-operation. Although all cases had severe diastolic failure, their systolic function was almost normal. Our study suggested that in patients with aortic valve disease, not PPM but diastolic heart failure correlated strongly with postoperative event and survival.
2002年3月至2005年8月，53例年龄在30至86岁之间的患者接受了主动脉瓣疾病的外科治疗。术前观察到15例（28.3%）存在舒张性心力衰竭。手术方式包括42例行主动脉瓣置换术（AVR）[其中3例行AVR和二尖瓣置换术（MVR）]，2例行主动脉瓣成形术（AVP），4例行主动脉根部置换术。同期手术包括2例行迷宫手术，6例行冠状动脉旁路移植术（CABG），15例行二尖瓣手术，8例行三尖瓣环成形术（TAP）。发生患者-人工瓣膜不匹配（PPM）7例[13.2%]。住院死亡2例（均为低心排血量综合征）。手术存活者中有2例发生晚期心脏相关并发症（均为心力衰竭）。无复发或再次手术情况。尽管所有病例均有严重舒张性心力衰竭，但其收缩功能几乎正常。我们的研究表明，在主动脉瓣疾病患者中，与术后事件和生存密切相关的不是PPM，而是舒张性心力衰竭。
