Wang R, Ma W G, Tian L X, Sun L Z, Chang Q
Department of Cardiovascular Surgery, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Thorac Cardiovasc Surg. 2010 Mar;58(2):76-80. doi: 10.1055/s-0029-1186277. Epub 2010 Mar 23.
We report our experience with aortic valve-sparing procedures in patients with Marfan syndrome and aortic root aneurysm.
Between August 2003 and July 2007, we performed aortic valve-sparing procedures in 20 patients with aortic root aneurysm resulting from Marfan syndrome. Mean age was 28 +/- 10 years (range, 10 to 57 years), and there were 9 females and 11 males. A reimplantation technique was used in 9 cases, a remodeling technique in 8 and a patch technique in 3 cases. Additional procedures included total aorta replacement in 1 patient, and aortic arch replacement plus stented elephant trunk in 2 patients. The mean follow-up time was 46 +/- 16 months (range, 17 to 64 months).
No in-hospital or late death occurred. Reexploration for bleeding was required in one case on postoperative day 1. No valve-related complications occurred during the follow-up period. At the end of follow-up, trivial or no aortic regurgitation was demonstrated in 14 patients, mild in 4 patients, moderate in 1 and severe in 1. Two patients with moderate and severe aortic regurgitation required reoperation.
The early and mid-term results of the valve-sparing operations were favorable, and the durability of the preserved valve should encourage use of this technique in patients with Marfan syndrome.
我们报告了对患有马凡综合征和主动脉根部瘤的患者进行保留主动脉瓣手术的经验。
2003年8月至2007年7月期间，我们对20例因马凡综合征导致主动脉根部瘤的患者进行了保留主动脉瓣手术。平均年龄为28±10岁（范围10至57岁），其中女性9例，男性11例。9例采用再植入技术，8例采用重塑技术，3例采用补片技术。另外的手术包括1例患者行全主动脉置换，2例患者行主动脉弓置换加带支架象鼻术。平均随访时间为46±16个月（范围17至64个月）。
无院内死亡或晚期死亡发生。1例患者术后第1天因出血需要再次手术探查。随访期间未发生与瓣膜相关的并发症。随访结束时，14例患者显示轻微或无主动脉瓣反流，4例患者为轻度，1例为中度，1例为重度。2例中度和重度主动脉瓣反流患者需要再次手术。
保留瓣膜手术的早期和中期结果良好，保留瓣膜的耐久性应促使在马凡综合征患者中使用该技术。
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