Oguma F, Hayashi J, Eguchi S
Second Department of Surgery, Niigata University School of Medicine.
Kyobu Geka. 1991 Jul;44(8 Suppl):669-73.
Twenty four patients underwent surgical treatment for ascending aortic lesions with aortic insufficiency at our institution. There were 16 male and 8 female patients from 12 to 67 years. Of 24 patients, 11 patients had Marfan's syndrome, and were younger at the time of operation. Three types of operative procedure were performed, that is, aortic valve replacement (AVR) and supracoronary graft replacement in 4 patients, AVR and covering the aneurysm of ascending aorta in 9, and composite graft replacement of the aortic valve and ascending aorta in 11. One patient died of perioperative myocardial infarction within 30 days after operation (early mortality rate, 4.2%). Another 5 patients died during the initial hospitalization, but no deaths were related to operative procedures. There was a total of 5 (27.8%) late deaths among the 18 patients follow-up with 5 and 10 years survival rate, 60.8%, 52.1%, respectively. Four of five patients was the cases with Marfan's syndrome. There were no statistically significant differences among three different procedures, but all patients who underwent composite graft replacement and left the hospital alive are doing well.
在我们机构，24例患者因升主动脉病变合并主动脉瓣关闭不全接受了手术治疗。患者年龄在12至67岁之间，其中男性16例，女性8例。24例患者中，11例患有马凡综合征，且手术时年龄较轻。实施了三种手术方式，即4例患者行主动脉瓣置换术（AVR）及冠状动脉上移植血管置换术，9例患者行AVR及升主动脉瘤覆膜术，11例患者行主动脉瓣及升主动脉复合移植血管置换术。1例患者术后30天内死于围手术期心肌梗死（早期死亡率为4.2%）。另有5例患者在初次住院期间死亡，但均与手术操作无关。在18例接受随访的患者中，共有5例（27.8%）晚期死亡，5年和10年生存率分别为60.8%、52.1%。5例患者中有4例为马凡综合征病例。三种不同手术方式之间无统计学显著差异，但所有接受复合移植血管置换术且出院后存活的患者情况良好。
