Morokuma Hiroyuki, Kamohara Keiji, Satoh Hisashi, Fumoto Hideyuki, Katayama Yuji, Rikitake Kazuhisa, Ohtsubo Satoshi, Yoshikai Masaru, Furukawa Kojiro, Morita Shigeki, Itoh Tsuyoshi
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga City, Saga, 849-8501, Japan.
Department of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, Nagasaki, Japan.
Surg Today. 2025 Apr 29. doi: 10.1007/s00595-025-03046-6.
The progression of aortic root dilation after remodeling remains unclear. This study investigated the geometric changes in aortic root morphology during the mid- to long-term period after aortic root remodeling in Japanese patients.
Seventy-six patients underwent aortic root remodeling between August 1996 and January 2022. We compared the echocardiographic findings of the aortic root morphology in the preoperative, early postoperative, and most recent late postoperative periods. The postoperative clinical outcomes were also assessed.
The mean preoperative diameters of the aortic annulus, sinus of Valsalva, and sinotubular junction were 25.2 ± 2.8 mm, 50.0 ± 7.6 mm, and 42.7 ± 9.5 mm, respectively. The mean grade of aortic regurgitation was 2.9°. Postoperatively, all diameters decreased significantly. The aortic annulus measured 21.3 ± 2.4 mm early postoperatively and 22.0 ± 2.4 mm late postoperatively, without significant enlargement over time. Ten patients required reoperation during the follow-up period; however, no significant aortic annulus enlargement was observed.
Aortic root remodeling preserved the aortic root morphology without any late enlargement of the aortic annulus, even in reoperation cases.
主动脉根部重塑后扩张的进展尚不清楚。本研究调查了日本患者主动脉根部重塑后中长期主动脉根部形态的几何变化。
1996年8月至2022年1月期间，76例患者接受了主动脉根部重塑。我们比较了术前、术后早期和最近术后晚期主动脉根部形态的超声心动图检查结果。还评估了术后临床结局。
主动脉瓣环、主动脉窦和窦管交界处的术前平均直径分别为25.2±2.8mm、50.0±7.6mm和42.7±9.5mm。主动脉反流的平均分级为2.9°。术后，所有直径均显著减小。术后早期主动脉瓣环测量值为21.3±2.4mm，术后晚期为22.0±2.4mm，未随时间显著增大。10例患者在随访期间需要再次手术；然而，未观察到主动脉瓣环显著增大。
主动脉根部重塑保留了主动脉根部形态，即使在再次手术的病例中，主动脉瓣环也没有晚期扩大。
