Kubo Sara, Hayashi Hiroyuki, Oka Takanori, Tsunemi Kotaro, Okada Kenji, Okita Yutaka
Cardio-aortic Center, Takatsuki General Hospital, Takatsuki, Japan.
Kyobu Geka. 2024 Jul;77(7):526-532.
We reported our long-term results of valve sparing aortic root replacement (VSRR) and aortic cusp repair for aortic regurgitation( AR) were satisfactory. Three hundred twenty-seven patients had VSRR, and 164 patients of them had aortic cusp repair for prolapse. At 10 years after the operation, the overall survival was 91.5%, the freedom from more than mild recurrent AR was 71.2%, and the freedom from aortic valve reoperation was 82.0%. As for the aortic cusp repair technique, there was no significant difference in the mid-term results of the recurrent AR and reoperation for the aortic valve between the central plication technique and the resuspension technique (two layers of continuous mattress sutures placed the entire length of the free margin of the aortic cusp). The resuspension technique might be useful for repairing the aortic cusp with prolapse. Furthermore, among the patients with acute aortic dissection, connective tissue disease, or aortitis, the long-term results of VSRR and aortic cusp repair were also satisfactory.
我们报告了保留瓣膜主动脉根部置换术(VSRR)和主动脉瓣叶修复治疗主动脉瓣反流(AR)的长期结果令人满意。327例患者接受了VSRR,其中164例患者因瓣叶脱垂接受了主动脉瓣叶修复。术后10年,总生存率为91.5%,无中重度复发性AR的生存率为71.2%,无需再次进行主动脉瓣手术的生存率为82.0%。至于主动脉瓣叶修复技术,中央折叠技术和瓣叶再悬吊技术(在主动脉瓣叶游离缘全长放置两层连续褥式缝线)在复发性AR和主动脉瓣再次手术的中期结果方面无显著差异。瓣叶再悬吊技术可能有助于修复脱垂的主动脉瓣叶。此外,在急性主动脉夹层、结缔组织病或主动脉炎患者中VSRR和主动脉瓣叶修复的长期结果也令人满意。