John R M, Pugsley W, Treasure T, Sturridge M F, Swanton R H
Department of Cardiology, Middlesex Hospital, London, U.K.
Eur Heart J. 1991 Feb;12(2):241-8. doi: 10.1093/oxfordjournals.eurheartj.a059875.
Fifty cases of aortic valve endocarditis during a 6-year period between 1982 and 1988 were reviewed. Twenty-three (46%) had aortic root complications by way of aortic root abscess or mycotic aneurysm in the perivalvular area. Patients with root complications were grouped into the aortic root abscess (ARA) group and those without into a non root abscess (NARA) group. Prosthetic valve endocarditis dominated in the ARA group (12 and four cases of prosthetic valve infection in the ARA and NARA groups, respectively; P less than 0.01). Surgical mortality was significantly higher at 13.6% in the ARA group as opposed to 2.2% in the NARA group (P less than 0.05). Post-operative aortic regurgitation was present in 8 (57%) of 14 patients in the ARA group surviving surgery but in only two (8.7%) of 23 patients in the NARA group (P less than 0.03). We conclude that aortic root complications are a frequent occurrence in aortic valve endocarditis, lead to an increased operative mortality and is associated with a high incidence of post-operative aortic regurgitation.
回顾了1982年至1988年6年间的50例主动脉瓣心内膜炎病例。23例（46%）因主动脉根部脓肿或瓣周区域的真菌性动脉瘤出现主动脉根部并发症。有根部并发症的患者被归入主动脉根部脓肿（ARA）组，无并发症的患者归入非根部脓肿（NARA）组。人工瓣膜心内膜炎在ARA组中占主导（ARA组和NARA组分别有12例和4例人工瓣膜感染；P<0.01）。ARA组的手术死亡率显著更高，为13.6%，而NARA组为2.2%（P<0.05）。ARA组14例术后存活的患者中有8例（57%）出现术后主动脉反流，而NARA组23例患者中只有2例（8.7%）出现（P<0.03）。我们得出结论，主动脉根部并发症在主动脉瓣心内膜炎中很常见，会导致手术死亡率增加，并与术后主动脉反流的高发生率相关。
