CAJ | 학술논문

目的分析升主动脉成形术治疗主动脉瓣病变伴升主动脉扩张病人的中期随访结果并总结其临床经验.方法 1996年10月至2007年4月对54例主动脉瓣病变伴升主动脉扩张的病人行主动脉瓣膜置换和升主动脉成形术,术后随访13～96个月,平均(23±16)个月.分别于术前、出院前及术后随访中,通过心脏超声检查测量升主动脉直径.结果围术期死亡2例.术前升主动脉直径(45.77±6.02)mm与出院前升主动脉直径(34.67±4.81)mm二者比较差异有统计学意义(P<0.01).术后随访升主动脉直径(37.65±6.35)砌与术前及术后出院前比较差异亦均有统计学意义(P<0.01).单纯主动脉瓣狭窄的基础病变和术后出院前升主动脉直径大于40mm是升主动脉再扩张的独立风险因素.结论升主动脉成形术中未用人工血管包裹治疗主动脉瓣病变伴升主动脉扩张或者升主动脉瘤的中期疗效欠佳.单纯主动脉瓣狭窄是这种术式的适应证,成形术必须将主动脉直径减至40mm以下,以减少远期再扩张.
목적 분석승주동맥성형술치료주동맥판병변반승주동맥확장병인적중기수방결과병총결기림상경험.방법 1996년10월지2007년4월대54례주동맥판병변반승주동맥확장적병인행주동맥판막치환화승주동맥성형술,술후수방13～96개월,평균(23±16)개월.분별우술전、출원전급술후수방중,통과심장초성검사측량승주동맥직경.결과 위술기사망2례.술전승주동맥직경(45.77±6.02)mm여출원전승주동맥직경(34.67±4.81)mm이자비교차이유통계학의의(P<0.01).술후수방승주동맥직경(37.65±6.35)체여술전급술후출원전비교차이역균유통계학의의(P<0.01).단순주동맥판협착적기출병변화술후출원전승주동맥직경대우40mm시승주동맥재확장적독립풍험인소.결론 승주동맥성형술중미용인공혈관포과치료주동맥판병변반승주동맥확장혹자승주동맥류적중기료효흠가.단순주동맥판협착시저충술식적괄응증,성형술필수장주동맥직경감지40mm이하,이감소원기재확장.
Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.