Faculty of Medicine and Health Technology, Tampere University Heart Hospital and Tampere University, SDSKIR, Elämänaukio 1, P.O. Box 2000, 33521, Tampere, Finland.
Fimlab Laboratories, Department of Pathology, Faculty of Medicine and Health Technology, Tampere University Hospital and Tampere University, Tampere, Finland.
J Cardiothorac Surg. 2024 Feb 2;19(1):41. doi: 10.1186/s13019-024-02587-0.
The extent of aortic valve inflammation in patients undergoing aortic valve replacement (AVR) is unsettled. The significance of aortic valve histopathology in patients undergoing AVR is undetermined.
A total of 145 resected aortic valves of consecutive patients undergoing surgery for a local aortic valve disease with or without ascending aorta were investigated for histopathology. The extent of inflammation and degeneration were investigated. Unadjusted survival was evaluated by Kaplan-Meier analysis. Median follow-up was 2.7 years (interquartile range 1.5-3.9).
Mean patient age was 69 (SD 11) years. Though endocarditis was apparent in only six patients preoperatively, severe aortic valve inflammation was diagnosed histologically in 32 patients of whom 12 patients had acute, subacute or chronic endocarditis. Despite complete aortic valve resection, survival was decreased in patients with severe aortic valve inflammation as opposed to those without (log rank, P = 0.044), even after exclusion of patients with endocarditis, emergency and aortic surgery.
Aortic valve tissue analysis reveals severe inflammation that may require postoperative treatment. The association of severe but local aortic valve inflammation with patient outcome after aortic valve surgery merits further investigation.
行主动脉瓣置换术（AVR）患者主动脉瓣炎症的程度尚不确定。行 AVR 患者主动脉瓣组织病理学的意义尚未确定。
共研究了 145 例连续接受局部主动脉瓣疾病手术的患者（伴或不伴升主动脉）的 145 个切除的主动脉瓣，以进行组织病理学检查。研究了炎症和退行性变的程度。Kaplan-Meier 分析评估未调整的生存率。中位随访时间为 2.7 年（四分位距 1.5-3.9）。
患者平均年龄为 69（11）岁。尽管术前仅有 6 例患者表现出明显的心内膜炎，但 32 例患者的主动脉瓣存在严重炎症，其中 12 例为急性、亚急性或慢性心内膜炎。尽管进行了完整的主动脉瓣切除，但与无严重主动脉瓣炎症的患者相比，严重主动脉瓣炎症患者的生存率降低（对数秩检验，P=0.044），甚至在排除心内膜炎、急诊和主动脉手术后也是如此。
主动脉瓣组织分析显示存在严重炎症，可能需要术后治疗。主动脉瓣手术后严重但局部的主动脉瓣炎症与患者预后相关，值得进一步研究。
