Valve-preserving aortic replacement:: Does the additional repair of leaflet prolapse adversely affect the results?

被引：66

作者：

Langer, F ^{[1
]}

Graeter, T ^{[1
]}

Nikoloudakis, N ^{[1
]}

Aicher, D ^{[1
]}

Wandler, O ^{[1
]}

Schäfers, HJ ^{[1
]}

机构：

[1] Univ Hosp Homburg, Dept Thorac & Cardiovasc Surg, D-66424 Homburg, Germany

来源：

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY | 2001年 / 122卷 / 02期

关键词：

D O I：

10.1067/mtc.2001.114635

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: Valve-preserving aortic replacement has evolved into an accepted therapeutic option for aortic ectasia with morphologically intact leaflets. Some patients, however, exhibit additional leaflet prolapse. We compared the results of established valve-preserving techniques with those of the combination of valve-preserving aortic surgery and additional repair of leaflet prolapse. Methods: Between October 1995 and March 2000, 99 patients underwent valve-preserving root replacement by means of root remodeling or valve reimplantation for acute dissection (n = 25), chronic dissection (n = 4). or aneurysm (n = 70). In group A (63 patients) either root remodeling (n = 49) or valve reimplantation (n 14) was performed with a standard technique. In group B (36 patients) valve-preserving aortic replacement (remodeling, n = 31: reimplantation. n = 5) was combined with repair of leaflet prolapse in the presence of bicuspid (n = 24) or tricuspid (n = 12) valve anatomy. Additional replacement of the aortic arch was required more frequently in group A (group A, n = 43; group B. n = 14: P =.006): otherwise, the groups were comparable. Results: Cardiopulmonary bypass (group A. 133 +/- 31 minutes: group B, 117 +/- 30 minutes; P =.006) and myocardial ischemia times (group A. 96 +/- 25 minutes: group B, 88 +/- 20 minutes; P =.05) were significantly longer in group A. Mortality was not significantly different between groups (group A, 4.8%; group B, 0%). One patient in each group underwent secondary valve replacement. and all other patients had stable valve function. Freedom from aortic regurgitation of grade 2 or greater after 48 months was 93.0% in both groups. Conclusion: Repair of leaflet prolapse in conjunction with valve-pre-serving root replacement leads to midterm results that are equal to those of valve-preserving root replacement for morphologically intact leaflets.

引用

页码：270 / 277

页数：8

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