Klinik für Herz- und thorakale Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany.
Eur J Cardiothorac Surg. 2013 Mar;43(3):585-90. doi: 10.1093/ejcts/ezs318. Epub 2012 Jun 4.
Sinuses of Valsalva are important in assuring the physiological function of the aortic valve. This study evaluates short-term clinical results of the reimplantation technique for aortic valve-sparing root replacement using a new prosthesis with three separate sinuses of Valsalva (sinus prosthesis).
Between February 2009 and February 2011, a total of 23 patients (20 m/3 f; mean age 52 ± 14.8 years; range 24-70 years) with aortic root aneurysm underwent aortic valve-sparing procedures according to the David reimplantation technique using the new sinus prosthesis. Eighteen patients had tricuspid and five patients bicuspid aortic valves. All patients received clinical as well as echocardiographic examinations postoperatively (mean 13 ± 9.3 months; 0.3-28 months).
There was no death and no reoperation of the aortic valve. At latest follow-up, most patients were in New York Heart Association class I (n = 22; 95.7%). In 95.7% aortic valve regurgitation (AR) was 0 or 1+; one patient had AR 2+. Pressure gradients were between the normal range (mean pressure gradient 4.7 ± 1.9 mmHg). Echocardiographic images demonstrate physiological aortic root dimensions and configuration with three separate sinuses of Valsalva without systolic contact of leaflets to the wall.
The new sinus prosthesis provides near normal root geometry and hemodynamics in valve-sparing aortic root replacement using the reimplantation technique, applicable for tricuspid and also bicuspid aortic valves.
瓦氏窦在保证主动脉瓣生理功能方面具有重要作用。本研究评估了使用具有三个独立瓦氏窦（窦假体）的新型假体进行主动脉瓣保留根部置换的再植入技术的短期临床结果。
2009 年 2 月至 2011 年 2 月，共有 23 例（20 例男性/3 例女性；平均年龄 52 ± 14.8 岁；范围 24-70 岁）主动脉根部瘤患者接受了根据 David 再植入技术使用新型窦假体进行的主动脉瓣保留手术。18 例患者为三尖瓣，5 例患者为二尖瓣主动脉瓣。所有患者术后均接受临床和超声心动图检查（平均 13 ± 9.3 个月；0.3-28 个月）。
无死亡，无主动脉瓣再次手术。在最新随访时，大多数患者心功能纽约分级为 I 级（n = 22；95.7%）。95.7%的主动脉瓣反流（AR）为 0 或 1+；1 例患者 AR 为 2+。压力梯度处于正常范围（平均压力梯度 4.7 ± 1.9mmHg）。超声心动图图像显示，在使用再植入技术进行主动脉瓣保留根部置换时，具有三个独立瓦氏窦的新窦假体提供了接近正常的根部几何形状和血液动力学，适用于三尖瓣和二尖瓣主动脉瓣。
新型窦假体在使用再植入技术进行主动脉瓣保留根部置换时提供了接近正常的根部几何形状和血液动力学，适用于三尖瓣和二尖瓣主动脉瓣。
