Köse Yiğit, Özyurt Köse Selen, Koçoğulları Cevdet Uğur
Department of Cardiovascular Surgery, Health Sciences University, Dr. Siyami Ersek Chest Heart and Vascular Surgery Training and Research Hospital, Istanbul, Türkiye.
Department of Neurology, Marmara University Pendik Training and Research Hospital, Istanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Apr 28;31(2):171-175. doi: 10.5606/tgkdc.dergisi.2023.24330. eCollection 2023 Apr.
This study aims to investigate the dilation of sinus valsalva in patients who underwent aortic repair due to type A aortic dissection and to evaluate its progression.
Between January 2004 and December 2019, a total of 68 patients (50 males, 18 females; mean age: 54.2±10.1 years; range, 30 to 82 years) who underwent root-preserving surgery and followed for at least one year in the outpatient setting were retrospectively analyzed. The patients were divided into two groups according to dilatation during follow-up. Group 1 (n=32) included patients with dilatation and Group 2 (n=36) included patients without dilatation. The sinus of Valsalva diameters were measured using pre- and postoperative computed tomography angiography.
The mean follow-up was 4.9±3.1 (range, 1 to 4) years. Sinus of Valsalva dilatation was observed in 47% of the patients during follow-up. Preoperative sinus of Valsalva diameter was a risk factor for aneurysmatic dilatation. A diameter of ≥4.05 cm was calculated as a cut-off value for developing dilatation requiring reoperation.
Follow-up using postoperative echocardiography or computed tomography angiography is of utmost importance for the assessment of development of sinus of Valsalva dilatation which requires reoperation in patients without intervention to the aortic root.
本研究旨在调查因A型主动脉夹层接受主动脉修复的患者的主动脉窦扩张情况，并评估其进展。
回顾性分析2004年1月至2019年12月期间共68例（男性50例，女性18例；平均年龄：54.2±10.1岁；范围30至82岁）接受保留主动脉根部手术并在门诊随访至少一年的患者。根据随访期间的扩张情况将患者分为两组。第1组（n = 32）包括有扩张的患者，第2组（n = 36）包括无扩张的患者。使用术前和术后计算机断层扫描血管造影测量主动脉窦直径。
平均随访时间为4.9±3.1（范围1至4）年。随访期间47%的患者观察到主动脉窦扩张。术前主动脉窦直径是动脉瘤样扩张的危险因素。计算得出直径≥4.05 cm为发生需要再次手术的扩张的临界值。
对于未对主动脉根部进行干预的患者，术后使用超声心动图或计算机断层扫描血管造影进行随访对于评估需要再次手术的主动脉窦扩张的发展至关重要。
