Outcome of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement.
Outcome of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement.
复制标题
主动脉瓣置换术后再次行主动脉根部或升主动脉置换术的结局。
DOI：
10.21037/jtd-20-3081
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发表时间：
2021-03
影响因子：
2.5
通讯作者：
Yu C
中科院分区：
文献类型：
--
作者：
Dun Y;Shi Y;Guo H;Liu Y;Qian X;Sun X;Yu C
关于既往主动脉瓣置换术 (AVR) 后再次手术主动脉根部或升主动脉置换术的临床结果的数据有限。我们的目的是分析既往 AVR 后再次手术主动脉根部或升主动脉置换术的结果。 80 名既往 AVR 患者在我院接受了再次主动脉根部或升主动脉置换术。适应症为根部或升主动脉瘤 36 例，根部或升主动脉夹层 37 例，根部假性动脉瘤 2 例，人工瓣膜心内膜炎 (PVE) 伴根部脓肿 2 例，白塞氏病 (BD) 伴根部破坏 3 例。 63 名患者进行了择期手术，17 名患者进行了紧急手术。通过 Kaplan-Meier 生存曲线和对数秩检验评估随访期间的生存率和无主动脉事件。手术技术包括升主动脉置换术（14 例）、升主动脉置换术（AVR）3 例、假体保留根部置换术（PSRR）35 例、Bentall 手术（24 例）和 Cabrol 手术（4 例）。手术死亡率为1.3% (1/80)。 5 名患者发生了复合不良事件，包括 1 例手术死亡、2 例中风和 3 例需要血液透析的肾功能衰竭。平均随访时间为 35.5±22.1 个月。发生五人晚期死亡。 1年、3年和6年的Kaplan-Meier生存率分别为97.5%、91.1%和84.1%。 3 名患者发生主动脉事件。 1 年、3 年和 6 年无主动脉事件发生率分别为 100%、96.3% 和 88.9%。择期组和紧急组之间的生存率和无主动脉事件没有差异。既往 AVR 后可进行再次主动脉根部或升主动脉置换术，以治疗 AVR 后的主动脉根部或升主动脉病变，并获得满意的早期和中期结果。
There are limited data regarding the clinical outcomes of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement (AVR). We aimed to analyze outcomes of reoperative aortic root or ascending aorta replacement after prior AVR. Eighty patients with prior AVR underwent reoperative aortic root or ascending aorta replacement in our hospital. The indications were root or ascending aortic aneurysm in 36 patients, root or ascending aortic dissection in 37, root false aneurysm in 2, prosthesis valve endocarditis (PVE) with root abscess in 2, Behçet’s disease (BD) with root destruction in 3 patients. An elective surgery was performed in 63 patients and an emergent surgery in 17. The survival and freedom from aortic events during the follow-up were evaluated with the Kaplan-Meier survival curve and the log-rank test. The operative techniques included ascending aorta replacement in 14 patients, ascending aorta replacement with AVR in 3, prosthesis-sparing root replacement (PSRR) in 35, Bentall procedure in 24, and Cabrol procedure in 4 patients. Operative mortality was 1.3% (1/80). A composite of adverse events occurred in 5 patients, including 1 operative death, 2 stroke and 3 renal failure necessitating hemodialysis. The mean follow-up was 35.5±22.1 months. Five late deaths occurred. The Kaplan-Meier survival at 1 year, 3 years and 6 years were 97.5%, 91.1% and 84.1%, respectively. Aortic events developed in 3 patients. The freedom from aortic events at 1-year, 3-year, and 6-year were 100%, 96.3% and 88.9%, respectively. There were no differences in survival and freedom from aortic events between the elective group and the emergent group. Reoperative aortic root or ascending aorta replacement after prior AVR could be performed to treat the root or ascending pathologies after AVR, with satisfactory early and midterm outcomes.
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影响因子：
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作者：
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DOI：
10.1016/j.jtcvs.2016.10.076
发表时间：
2017-06-01
影响因子：
6
作者：
Preventza, Ourania;Coselli, Joseph S.;Green, Susan
通讯作者：
Green, Susan