Department of Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
J Card Surg. 2022 Mar;37(3):532-534. doi: 10.1111/jocs.16152. Epub 2021 Nov 24.
Patients with a bicuspid aortic valve (BAV) are at increased risk of valvular regurgitation compared to their counterparts with a tri-leaflet aortic valve. There is now increasing emphasis to offer BAV repair to mitigate the risks of prosthesis-related complications, including thromboembolism, hemorrhage and endocarditis, as well as structural valve deterioration and future reoperation with conventional valve replacement, particularly in younger populations. Furthermore, over the preceding two decades, our greater understanding of the functional anatomy of the BAV, pathophysiological mechanisms of BAV insufficiency, and the development of a functional classification of aortic regurgitation have significantly contributed to the evolution of aortic valve reconstructive surgery. In this commentary, we discuss a recent article from the Journal of Cardiac Surgery comparing external annuloplasty and subcommissural annuloplasty as techniques for BAV repair.
与三叶瓣主动脉瓣相比，二叶瓣主动脉瓣患者发生瓣叶反流的风险增加。现在越来越强调对二叶瓣主动脉瓣进行修复，以降低与假体相关并发症的风险，包括血栓栓塞、出血和心内膜炎，以及结构性瓣膜退化和未来用传统瓣膜置换进行再次手术，尤其是在年轻人群中。此外，在过去的二十年中，我们对二叶瓣的功能解剖、二叶瓣功能不全的病理生理机制以及主动脉瓣反流的功能分类的理解的加深，极大地促进了主动脉瓣重建手术的发展。在这篇评论中，我们讨论了《心脏外科学杂志》上的一篇最新文章，该文章比较了外部瓣环成形术和瓣下环成形术作为二叶瓣修复技术的效果。
