Antunes M J, Baptista A L, Colsen P R, Kinsley R H
Thorax. 1984 Apr;39(4):305-10. doi: 10.1136/thx.39.4.305.
From January 1979 to June 1982 31 patients have had simultaneous ascending aortic aneurysm repair and aortic valve replacement. Fifteen patients (group 1) received a composite graft; seven patients (group 2) had separate aortic valve and supracoronary ascending aorta prostheses; and nine patients (group 3) had aortic valve replacement and "tailoring" of the ascending aorta. The mean age was 50 (SD 14) years. Nine patients had acute dissection, five with the coronary ostia affected. Emergency surgery was performed in 10 cases. There were six early deaths (19.4%), none of them due to technical complications during surgery. The mortality rate was 56% for patients with acute dissection operated on as an emergency and 4.5% for patients having elective operations. Appreciable haemorrhage occurred in four patients (12.9%). No neurological complications occurred. There was one late death. The survivors were followed up for one to four years. There was one case of recurrence of aneurysm. No ischaemic complications resulted from coronary reimplantation. There were no significant differences in the results of the three groups. Simultaneous ascending aortic aneurysm repair and aortic valve replacement can be accomplished with an acceptable mortality rate and little morbidity.
1979年1月至1982年6月，31例患者同时接受了升主动脉瘤修复和主动脉瓣置换术。15例患者（第1组）接受了复合移植物；7例患者（第2组）使用了单独的主动脉瓣和冠状动脉上的升主动脉假体；9例患者（第3组）接受了主动脉瓣置换和升主动脉“剪裁”。平均年龄为50（标准差14）岁。9例患者为急性夹层，5例冠状动脉开口受累。10例患者进行了急诊手术。有6例早期死亡（19.4%），均非手术技术并发症所致。急诊手术的急性夹层患者死亡率为56%，择期手术患者死亡率为4.5%。4例患者（12.9%）出现明显出血。未发生神经系统并发症。有1例晚期死亡。对幸存者进行了1至4年的随访。有1例动脉瘤复发。冠状动脉再植未导致缺血性并发症。三组结果无显著差异。同时进行升主动脉瘤修复和主动脉瓣置换术可实现可接受的死亡率和较低的发病率。
