摘要
目的探索主动脉窦成形在修复急性Stanford A型主动脉夹层受累根部中的可行性、有效性和效果的持久性。方法从2014年1月至2017年7月,共43例急性Stanford A型主动脉夹层患者在我院接受了主动脉窦成形术修复受累的主动脉根部,其中男34例、女9例,年龄32~65(50.1±8.1)岁。回顾性分析患者的围术期和随访资料,对术前、术后和随访时的超声指标进行统计分析。结果全部患者30 d死亡率为4.7%(2例),5例患者行连续性肾脏替代治疗,1例患者因出血行再次开胸手术。无患者因脆弱的主动脉根部组织出血而接受再次手术。所有患者术前的主动脉瓣反流在术后即刻得以纠正,假腔同时被完全消除。随访时间为18~45(27.9±6.7)个月,随访期间无远期死亡,2例失访。接受随访的39例患者中,无主动脉根部及主动脉瓣的再次干预,未发现根部存在残余夹层,无显著的根部扩张。比较出院时和随访时的主动脉根部直径和主动脉瓣反流程度,差异无统计学意义。结论修复在急性Stanford A型主动脉夹层中严重受累的主动脉根部,主动脉窦成形术是一种简便可靠的方法,近期效果优异。
Objective To investigate the feasibility, effectiveness and durability of aortic sinoplasty in repairing aortic roots of patients with acute type A aortic dissection. Methods From January 2014 to July 2017, 43 consecutive patients with acute type A aortic dissection underwent aortic sinoplasty to repair aortic root in our institution, including 34 males and 9 females, aged 32-65(50.1±8.1) years. The perioperative and follow-up data were retrospectively analyzed, and statistical analysis on the preoperative, postoperative and follow-up ultrasound indicators was performed. Results Thirty-day mortality was 4.7%. Preoperative aortic regurgitation was corrected and false lumen was eliminated immediately after operation in all patients. There was no late death, or aortic root or valve re-intervention and two patients were lost during a follow-up of 18-45(27.9±6.7) months. There was no residual dissection found. No patients had significant dilation of aortic root. No statistically significant difference was found when comparing the maximum of root diameter and aortic regurgitation grade between at discharge and follow-up. Conclusion Aortic sinoplasty for aortic root repair in acute type A aortic dissection is a simple and reliable technique and demonstrates excellent early outcomes.
作者
畅怡
钱向阳
郭宏伟
魏以桢
史艺
CHANG Yi;QIAN Xiangyang;GUO Hongwei;WEI Yizhen;SHI Yi(Department of Vascular Surgery,Fu Wai Hospital,Chinese Academy of Medical Sciences,National Center for Cardiovascular Diseases,Beijing,100037,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第12期1441-1446,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery