二叶性主动脉瓣畸形外科治疗114例分析

Surgical Management of Congenital Bicuspid Aortic Valve in 114 Cases

目的:探讨二叶式主动脉瓣畸形(CBAV)疾病的发病特点、外科治疗及并发症。方法:回顾性分析经外科手术治疗的CBAV患者共114例。结果:男性患者居多(78.0%);合并其他心血管畸形14例,以主动脉狭窄为主(11例),合并主动脉瓣狭窄(77例)及或关闭不全(37例),主动脉瓣钙化(19例),主动脉瓣脱垂(10例),升主动脉扩张(28例),感染性心内膜炎(5例);手术以主动脉瓣膜置换为主(n=104例),术后并发症包括出血7例、低心排6例、新发房颤2例及新发室颤2例,死亡2例。结论:先天性CBAV多于中年时出现症状,多见于男性,主要并发症为主动脉瓣狭窄。手术方式主要以主动脉瓣膜置换为主,心绞痛、感染性心内膜炎及术前心功能低下者手术风险性较高。

Objective：To investigate characteristics,surgical management and complications of congenital bicuspid aortic valve（CBAV）. Methods：A retrospective analysis in 114 patients with CBAV underwent surgical management.Results：The majority patients was male（78.0%）;combined with other cardiovascular malformations in 14 cases,mainly was aortic stenosis （11 cases）,aortic stenosis （77 cases） and or regurgitation （37 cases）,aortie valve calcification （19 cases）,aortic valve prolapse （10 cases）,ascending aortic dilatation （28 cases）,infective endocarditis （5 cases）;Aortic valve replacement was the main surgical method（n=104 cases）,postoperative complications included bleeding in 7 cases,6 cases of low cardiac output,new onset atrial fibrillation in 2 cases and emerging ventricular fibrillation in 2 cases.2 deaths.Conclusion： The symptoms of CBAV appeared in middle age,more common in men.The main comitant is aortic valve stenosis.Aortic valve replacement is main surgical management.The risk in angina, infective endocarditis,and patients with poor cardiac function before the surgical is high.