自体心包行主动脉窦部重建治疗A型主动脉夹层根部的近期疗效

Short-Term Effect of Autologous Pericardial Reconstruction of Aortic Sinus in the Treatment of Root of Type A Aortic Dissection

目的探讨自体心包行主动脉窦部重建在治疗A型主动脉夹层根部的近期疗效。方法选取郑州大学第一附属医院2018年1月至2020年3月42例根部运用自体心包行窦部重建的A型主动脉夹层患者,回顾性分析患者的围手术期和随访资料,对术前、出院时和术后1a的心脏超声指标进行统计学分析。结果患者院内死亡3例,治愈出院39例,所有患者的主动脉窦部内径和主动脉瓣反流在术后得到改善,差异有统计学意义(P<0.05)。术后随访1a,随访期间无失访和死亡病例,无二次手术干预病例,未发现根部存在残余夹层,术后1a时窦部内径和出院时相比,无明显增宽,无中度以上的主动脉瓣的反流,差异无统计学意义(P>0.05)。结论自体心包行窦部重建是一种有效的根部处理方式,该方法保留主动脉瓣结构和功能,防止窦部进一步扩张,近期临床效果显著。

Objective To investigate the short-term effect of autologous pericardial reconstruction of aortic sinus in the treatment of the root of type A aortic dissection.Methods The perioperative and follow-up data of 42 patients with type A aortic dissection reconstructed by autologous pericardium in the First Affiliated Hospital of Zhengzhou University from January 2018 to March 2020 were analyzed retrospectively.The echocardiographic indexes before operation,at discharge and 1 year after operation were statistically analyzed.Results A total of 3 patients died in hospital,and 39 patients were cured and discharged.The internal diameter of aortic sinus and aortic regurgitation of all patients were improved after operation(P<0.05).During the follow-up for 1 year,there were no loss of follow-up and death,no secondary surgical intervention,no residual dissection in the root.There were no significant widening of sinus diameter and no moderate aortic valve regurgitation 1 year after operation(P>0.05).Conclusion Sinus reconstruction with autologous pericardium is an effective method for root management.This method preserves the structure and function of aortic valve and prevents further dilatation of sinus,and short-term effects are significant.