Ogino Hitoshi
Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
Kyobu Geka. 2019 Jan;72(1):63-77.
The preservation and repair of the aortic valve, since its valve annulus and leaflets have anatomically complicated 3-dimensional structures, is technically demanding with challenging aspects, and has not been a general surgical treatment, yet. However, in the recent trend of sparing and repair of the native valves in the cardiac surgical field, for aortic root diseases in relatively younger patients, valve sparing aortic root replacement has been attempted with the favorable outcome. In terms of its indication, such technically demanding surgeries had previously been indicated predominantly for patients without any valve deformities and significant aortic valve regurgitation, however in recent years, through the expanding indication with technical advances, they have been performed even for cases with some valve deformities including regurgitant bicuspid aortic valves. In this section, an up-to-data review would be described on valve sparing aortic root replacement, including its current indication, surgical techniques, and recent topics for discussion.
由于主动脉瓣的瓣环和瓣叶具有解剖结构复杂的三维结构，主动脉瓣的保存和修复在技术上要求很高且具有挑战性，目前尚未成为一种常规的外科治疗方法。然而，在心脏外科领域保留和修复自体瓣膜的最新趋势下，对于相对年轻患者的主动脉根部疾病，已尝试进行保留瓣膜的主动脉根部置换术，且效果良好。就其适应症而言，此类技术要求较高的手术以前主要适用于没有任何瓣膜畸形和明显主动脉瓣反流的患者，然而近年来，随着技术进步适应症不断扩大，甚至对于一些存在瓣膜畸形（包括反流性二叶式主动脉瓣）的病例也开展了此类手术。在本节中，将对保留瓣膜的主动脉根部置换术进行最新综述，包括其当前适应症、手术技术和近期讨论的话题。
