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奥扎基手术在小儿主动脉瓣反流中单叶重建。

Single leaflet reconstruction in paediatric aortic regurgitation using the Ozaki procedure.

机构信息

Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China.

Department of Cardiovascular Surgery, Children's Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.

出版信息

Cardiol Young. 2022 May;32(5):789-793. doi: 10.1017/S1047951121003164. Epub 2021 Aug 2.

Abstract

OBJECTIVES

Aortic valve repair in children is still a challenge. The aim of this study was to analyse the surgical results of children with aortic regurgitation who underwent single leaflet reconstruction using the Ozaki procedure in our medical centre.

METHODS

A retrospective study was conducted of nine children with aortic regurgitation who received single leaflet reconstruction from May 2017 to September 2019. Paired t-tests and Wilcoxon signed rank tests were used to compare the data at different time points.

RESULTS

The median surgical age was 4.7 (3.5, 6.4) years. Eight patients were pre-operatively diagnosed with severe aortic regurgitation, while one had moderate regurgitation. The left ventricles were significantly enlarged, with an average z-score of 3.8. Single leaflet reconstruction was carried out using glutaraldehyde-treated autologous pericardium under the standard Ozaki procedure. The median follow-up was 22 (14, 33) months. There was no post-operative death or re-intervention. One patient had moderate or more aortic regurgitation during the follow-up. The average degree of aortic regurgitation was mild, and the average z-score of the left ventricle decreased to -0.2 in the last follow-up.

CONCLUSIONS

Single leaflet reconstruction using the Ozaki procedure was an effective surgical method for treating children with aortic regurgitation in our centre with satisfactory short-term results.

摘要

目的

儿童主动脉瓣修复仍然是一个挑战。本研究旨在分析在我们医疗中心接受 Ozaki 手术进行单瓣叶重建的主动脉瓣反流患儿的手术结果。

方法

回顾性分析 2017 年 5 月至 2019 年 9 月期间接受单瓣叶重建的 9 例主动脉瓣反流患儿的临床资料。采用配对 t 检验和 Wilcoxon 符号秩检验比较不同时间点的数据。

结果

患儿的中位手术年龄为 4.7(3.5,6.4)岁。8 例患儿术前诊断为重度主动脉瓣反流,1 例为中度反流。左心室明显增大,平均 z 值为 3.8。采用戊二醛处理的自体心包膜按照标准 Ozaki 手术进行单瓣叶重建。中位随访时间为 22(14,33)个月。术后无死亡或再次干预。1 例患儿在随访中出现中度或以上主动脉瓣反流。平均主动脉瓣反流程度为轻度,最后一次随访时左心室 z 值平均降低至-0.2。

结论

Ozaki 手术的单瓣叶重建是治疗我们中心主动脉瓣反流患儿的有效手术方法,短期结果满意。

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