Mitchell Max B, Goldberg Steven P
Department of Surgery, University of Colorado at Denver Health Sciences Center, Denver, CO, USA.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2011;14(1):85-91. doi: 10.1053/j.pcsu.2011.01.013.
Supravalvar aortic stenosis (SVAS) is a rare anomaly of the aortic root caused by a genetically based deficiency in elastin production. Concomitant primary and secondary cardiovascular lesions complicate surgical management and impact early and late outcomes. Because SVAS is a rare lesion, surgical series are relatively small and span lengthy time periods. Consequently, risk factors that influence early and late outcomes are not well defined. Patients who come to surgery during infancy are particularly challenging, but little attention has been directed as to whether or not young age influences outcomes. This review suggests that complicating associated features of elastin arteriopathy are more prevalent in patients who require relief of SVAS during infancy, and that concomitant lesions significantly increase the difficulty and risk of treating younger patients with SVAS.
瓣上主动脉狭窄(SVAS)是一种由弹性蛋白生成的基因缺陷引起的主动脉根部罕见异常。原发性和继发性心血管病变并存使手术管理复杂化,并影响早期和晚期结果。由于SVAS是一种罕见病变,手术系列相对较小且跨越较长时间段。因此,影响早期和晚期结果的危险因素尚未明确界定。婴儿期接受手术的患者尤其具有挑战性,但对于年龄小是否影响结果却很少受到关注。本综述表明,弹性蛋白动脉病的相关复杂特征在婴儿期需要缓解SVAS的患者中更为普遍,并且并存病变显著增加了治疗年轻SVAS患者的难度和风险。