De Paulis Ruggero
Department of Cardiac Surgery, European Hospital, Via Portuense 700, 00151, Rome, Italy.
Gen Thorac Cardiovasc Surg. 2019 Jan;67(1):77-81. doi: 10.1007/s11748-017-0837-2. Epub 2017 Oct 10.
The remodeling and the reimplantation procedures were described more than 25 years ago with the aim of sparing, otherwise normal aortic valve in the presence of a root aneurysm. Because of its ability to reconstruct the sinuses of Valsalva, the remodeling procedure was considered to be more physiological than the reimplantation. However, because the remodeling lacked annular stabilization, the long-term stability of the procedure was questioned. However, through the years, both procedures have been significantly improved, so that is now possible to perform a reimplantation procedure with neo-sinuses reconstruction or a remodeling procedure with annular stabilization. In this way, both procedures can now guarantee an anatomical root reconstruction and an increased long-term durability. Today preference for a reimplantation procedure is based on the perception of a better reproducibility of the surgical procedure, an increased procedural safety due to the characteristic hemostatic feature of this surgical approach, and to a much larger amount of data present in the literature on long-term results.
25年多前就已描述了重塑和再植入手术，其目的是在存在根部动脉瘤的情况下保留原本正常的主动脉瓣。由于其能够重建主动脉窦，重塑手术被认为比再植入手术更符合生理。然而，由于重塑缺乏瓣环稳定，该手术的长期稳定性受到质疑。然而，多年来，这两种手术都有了显著改进，现在可以进行新窦重建的再植入手术或瓣环稳定的重塑手术。通过这种方式，现在这两种手术都可以保证进行解剖学根部重建并提高长期耐久性。如今，对再植入手术的偏好基于对手术更好的可重复性的认知、由于这种手术方法特有的止血特性而提高的手术安全性，以及文献中关于长期结果的大量数据。
