Girdauskas Evaldas, Petersen Johannes, Sachweh Jörg, Kozlik-Feldmann Rainer, Sinning Christoph, Rickers Carsten, von Kodolitsch Yskert, Reichenspurner Hermann
Department of Cardiac and Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
German Center of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Cardiovasc Diagn Ther. 2018 Dec;8(6):789-798. doi: 10.21037/cdt.2018.11.01.
Aortic valve repair in adult congenital heart disease (ACHD) went through a major development during the last two decades to become an increasingly established treatment option in experienced heart valve repair centers. This mini-review addresses valve-sparing treatment strategies in the two most common clinical entities of patients with adult congenital aortic valve disease, namely those presenting with bicuspid (BAV) and unicuspid (UAV) aortic valve disease. Both diseases are integral components of the continuum of congenital aortic valve diseases and represent one of the most common reasons of cardiovascular morbidity in young and otherwise healthy adult patients. The review will highlight the most important advantages of aortic valve sparing procedures as compared to the conventional valve replacement strategy. New treatment aspects will be reviewed including minimally-invasive surgical approaches for aortic valve repair as well as modern protocols of enhanced perioperative recovery which will potentially improve the perioperative recovery and quality of life of the patients undergoing valve-sparing surgical procedures in the future.
在过去二十年中，成人先天性心脏病（ACHD）的主动脉瓣修复取得了重大进展，在经验丰富的心脏瓣膜修复中心已日益成为一种成熟的治疗选择。本综述探讨了成人先天性主动脉瓣疾病两种最常见临床类型患者的保留瓣膜治疗策略，即患有二叶式（BAV）和单叶式（UAV）主动脉瓣疾病的患者。这两种疾病都是先天性主动脉瓣疾病连续谱的组成部分，也是年轻且原本健康的成年患者心血管发病的最常见原因之一。本综述将强调与传统瓣膜置换策略相比，保留主动脉瓣手术的最重要优势。还将回顾新的治疗方面，包括主动脉瓣修复的微创手术方法以及现代的围手术期加速康复方案，这些方案未来可能会改善接受保留瓣膜手术患者的围手术期恢复情况和生活质量。
