Chen Joshua R, Shah Vishal N, Koeneman Scott H, King Colin, McGee Jacqueline, Plestis Konstadinos
Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Division of Biostatistics and Bioinformatics, Thomas Jefferson University, Philadelphia, Pennsylvania.
Aorta (Stamford). 2025 Apr;13(2):46-55. doi: 10.1055/a-2642-8919. Epub 2025 Jul 19.
Valve-sparing root replacement (VSRR) is an alternative to traditional valve-replacing root replacement. We examined early- and mid-term outcomes after VSRR.We performed a retrospective review of a prospectively maintained aortic registry. All patients undergoing VSRR from 2005 to 2023 were included. Statistical analysis was performed in R version 4.3.1. Kaplan-Meier curves were used to describe mortality and freedom from mortality, aortic insufficiency (AI) > 1 + , and aortic valve-related reoperation.Eighty-one patients underwent VSRR, 59 (72.8%) through full sternotomy (FS) and 22 (27.2%) through upper hemisternotomy. There were no cases of AI > 1+ in the perioperative period, 1 (1.2%) stroke, and no in-hospital mortality. Mean intensive care unit and hospital stay were 3 and 7 days, respectively. Mean follow-up time was 8 years. Freedom from all-cause mortality at 1, 5, and 10 years was 100, 96.6, and 94.4%, respectively. Composite freedom from reoperation, recurrence, or mortality at 1, 5, and 10 years was 98.8, 92.1, and 87.3%, respectively.With careful preoperative selection, VSRR is a durable procedure for patients with aortic root aneurysm.
保留瓣膜的主动脉根部置换术（VSRR）是传统瓣膜置换根部置换术的一种替代方法。我们研究了VSRR后的早期和中期结果。我们对前瞻性维护的主动脉登记处进行了回顾性研究。纳入了2005年至2023年期间所有接受VSRR的患者。在R 4.3.1版本中进行统计分析。采用Kaplan-Meier曲线描述死亡率和无死亡、主动脉瓣关闭不全（AI）>1+以及主动脉瓣相关再次手术的情况。81例患者接受了VSRR，59例（72.8%）通过全胸骨切开术（FS），22例（27.2%）通过上半胸骨切开术。围手术期无AI>1+的病例，1例（1.2%）发生卒中，无院内死亡。重症监护病房平均住院时间和住院时间分别为3天和7天。平均随访时间为8年。1年、5年和10年的全因死亡率分别为100%、96.6%和94.4%。1年、5年和10年再次手术、复发或死亡的综合无事件率分别为98.8%、92.1%和87.3%。经过仔细的术前选择，VSRR对主动脉根部瘤患者是一种持久的手术方法。
