McGoon法与Doty法矫治主动脉瓣上狭窄的比较研究

Comparative Study of McGoon procedure and Doty procedure for Supravalvular Aortic Stenosis

目的比较McGoon法与Doty法矫治主动脉瓣上狭窄(SVAS)的临床结果。方法 1996年10月至2008年10月外科治疗SVAS病例80例,入选本研究的患者58例。其中McGoon法矫治组35例,Doty法矫治组23例。分析比较两组术中体外循环时间,升主动脉阻断时间,术后胸腔引流量,主动脉左心室压差,主动脉瓣关闭不全发生率及术后远期主动脉左心室压差,主动脉瓣关闭不全发生率的差异。结果两组术中体外循环时间,升主动脉阻断时间,术后胸腔引流量,主动脉左心室压差,主动脉瓣关闭不全发生率均无明显差异(P>0.05)。两组随访时间分别为(4.0±3.5)年及(4.5±4.2)年。随访期间,无再手术病例及死亡病例;两组主动脉左心室压差,主动脉瓣关闭不全发生率无明显差异(P>0.05)。结论 McGoon法与Doty法矫治主动脉瓣上狭窄均能获得满意的近期及远期临床结果。

Objective Comparative study the clinic results of McGoon procedure and Doty procedure for supravalvular aortic stenosis（SVAS）.Methods Form October 1996 to October 2008,eighty patients with SVAS underwent aortoplasty.Fifty-eight of them were selected for the comparative study.Thirty-five of the selected patients were performed McGoon procedure and twenty of them were performed Doty procedure.The present study compared the CPB time,the aortic clamp time,the volume of thoracic effusion,the systolic pressure gradient across aortic valve and the percentage of aortic valve regurgitation.Results There was no significant difference between McGoon procedure and Doty procedure about the CPB time,the aortic clamp time,the volume of thoracic effusion,the systolic pressure gradient across aortic valve and the percentage of aortic valve regurgitation.Mean follow-up was（4.0±3.5） years and（4.5±4.2）years respectively.There was no reoperation and no death during follow-up.There was no significant difference between McGoon procedure and Doty procedure about the systolic pressure gradient across aortic valve and the percentage of aortic valve regurgitation during fellow up.Conclusions Both McGoon procedure and Doty procedure for supravalvular aortic stenosis can get satisfactory early and long term clinic results.