Ozaki手术在小儿主动脉瓣反流中的应用

Application of Ozaki operation in treatment of aortic regurgitation in children

目的探讨Ozaki手术在儿童主动脉瓣反流(aortic regurgitation,AR)中的早期应用结果。方法回顾性分析我院2017年4月至2019年7月间15例中重度AR患儿的临床资料,其中男11例、女4例,平均手术年龄(10.7±3.7)岁,均行Ozaki手术(主动脉瓣叶置换)治疗AR。在术前,术后1 d、1周、1个月、3个月、6~12个月分别评估AR及心功能。结果14例(93.3%)患儿在术后1 d、1个月、3个月以及6~12个月时新主动脉瓣瓣叶对合良好,反流为Ⅰ~Ⅱ级,较术前明显好转(P=0.001)。术后患儿心功能恢复快,术后1 d、1个月、3个月以及6~12个月左心室射血分数均与术前的差异无统计学意义(P>0.05)。无血栓等不良并发症,无患儿死亡。结论Ozaki方法重建三瓣化的主动脉瓣叶治疗小儿严重AR的近期手术疗效良好,其瓣膜功能的持久性有待中长期随访明确。

Objective To explore the early results of Ozaki operation in children with aortic regurgitation.Methods We retrospectively analyzed the clinical data of 15 patients with aortic regurgitation who received the Ozaki operation in our hospital from April 2017 to July 2019.There were 11 males and 4 females with an average operation age of 10.7±3.7 years.Besides preoperative evaluation,aortic regurgitation and cardiac function were evaluated on 1 day,1 week,1 month,3 months,and 6-12 months after surgery.Results In 14(93.3%)patients,the aortic valve leaflets functioned well on 1 day,1 month,3 months,and 6-12 months,and the regurgitation grade wasⅠ-Ⅱ,which was improved than before(P=0.001).The cardiac function of children recovered quickly after operation.There was no statistical difference in ejection fraction on 1 day,1 month,3 months,and 6-12 months after operation(P>0.05).No children died,and no other clinical event was found.Conclusion The Ozaki technique of reconstructing a tricuspid aortic valve leaflet for the treatment of severe aortic regurgitation in children is effective in short term,and the persistence of its valve function remains to be determined in the long-term follow-up.