Department of Pediatric Cardiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
J Cardiol. 2013 Jan;61(1):16-21. doi: 10.1016/j.jjcc.2012.08.018. Epub 2012 Nov 21.
Longer survival after corrective surgery for congenital heart diseases has rendered late complications more important. One of these complications is aortic dilatation which may occur in patients with repaired or unrepaired disease and can progress to aneurysm, dissection, and rupture. This aortic dilatation in various congenital heart diseases does not simply mean anatomical dilatation of the aortic root, but it closely relates to the aortic pathophysiological abnormality, aortic regurgitation, and aortic and ventricular dysfunction; therefore, we can recognize this complex lesion as a new concept: "aortopathy". The pathophysiology of this disease is complex and only partially understood. In this review, we first discuss history, pathophysiology, and clinical features of aortic dilatation and aortopathy of congenital heart disease. Then we provide a review of the evaluation and management of this disease.
先天性心脏病患者手术后生存时间延长,使得晚期并发症变得更加重要。其中一种并发症是主动脉扩张,可发生于先天性心脏病已修复或未修复的患者,可进展为动脉瘤、夹层和破裂。各种先天性心脏病的这种主动脉扩张不仅仅是主动脉根部的解剖学扩张,而是与主动脉病理生理学异常、主动脉瓣反流以及主动脉和心室功能障碍密切相关;因此,我们可以将这种复杂病变识别为一个新概念:“主动脉病”。这种疾病的病理生理学很复杂,目前只部分了解。在这篇综述中,我们首先讨论了先天性心脏病主动脉扩张和主动脉病的历史、病理生理学和临床特征。然后,我们对该疾病的评估和管理进行了综述。