The surgical outcomes of aortic valve replacement in patients with aortic valve lesions caused by Behcet's disease: lessons we learned.
The surgical outcomes of aortic valve replacement in patients with aortic valve lesions caused by Behcet's disease: lessons we learned.
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DOI：
10.21037/atm-21-5673
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发表时间：
2021-10
影响因子：
--
通讯作者：
Wang C
中科院分区：
文献类型：
--
作者：
Sun X;Yuan L;Liu J;Yang Q;Liu H;Zhang H;Wang C
对于有主动脉根部病变的Behcet病患者，疾病常表现为主动脉瓣反流（aortic valve reflux， AR）。在主动脉瓣置换术（AVR）后，许多患者经常出现瓣周渗漏和瓣裂，需要第二次或第三次手术。在这项研究中，我们报告了20例接受AVR治疗由Behcet病引起的主动脉根部病变的患者的结果，以及我们学到的经验教训。2013年10月至2019年9月，共有50名Behcet病患者在我院接受了AVR。其中术前未确诊的15例行孤立性AVR。其他5例患者术前诊断并行改良AVR。所有患者都被联系进行随访。使用超声心动图评估瓣膜功能。15例术前未确诊患者[年龄：38.4±12.6岁（范围：24-63岁）；9名男性，6名女性]接受了孤立性AVR作为主要手术。超声心动图显示13例（86.7%）患者术后发生瓣膜破裂，平均间隔10.8±8.4个月。这些患者接受了第二次手术，其中1例因远端吻合处假性动脉瘤接受了第三次手术。其他5例患者[年龄：38.8±9.5岁（范围：27-55岁）；4例（男1例，女1例）行改良AVR，超声心动图随访期间均未观察到AR或人工瓣膜脱离，且无患者需要二次手术。对于伴有AR的白塞病患者，孤立AVR后瓣膜破裂的发生率较高。与传统AVR相比，我们发现改良AVR是接受标准化术前治疗的患者的最佳选择。
For Behcet’s disease patients with aortic root lesions, the disease often manifests as aortic valve regurgitation (AR). Following aortic valve replacement (AVR), many of these patients often suffer perivalvular leakage and valve dehiscence, requiring a second or third operation. In this study, we report the outcomes of 20 patients who underwent AVR to manage aortic root lesions caused by Behcet’s disease, and the lessons we learned. From October 2013 to September 2019, a total of 50 patients with Behcet’s disease underwent AVR at our institution. Among them, isolated AVR was performed in 15 preoperatively undiagnosed cases. The other 5 patients were preoperatively diagnosed and underwent modified AVR. All patients were contacted for a follow-up. Valve function was evaluated using echocardiography. The 15 preoperatively undiagnosed patients [age: 38.4±12.6 years (range, 24–63 years); 9 males, 6 females] underwent isolated AVR as their primary procedure. Echocardiography revealed that valve dehiscence occurred in 13 (86.7%) patients postoperatively after a mean interval of 10.8±8.4 months. These patients accepted a second operation, and 1 of them accepted a third operation because of a pseudoaneurysm of the distal anastomosis site. For the other 5 patients [age: 38.8±9.5 years (range, 27–55 years); 4 males, 1 female] who underwent modified AVR, neither AR nor prosthetic valve detachment were observed during the echocardiography follow-up, and none required a secondary operation. For behcet’s disease patients with AR, there was a high rate of valve dehiscence after isolated AVR. When compared with traditional AVR, we found that modified AVR was the optimal choice for patients who received standardized preoperative treatment.
影响因子：
2.5
作者：
Dun Y;Shi Y;Guo H;Liu Y;Qian X;Sun X;Yu C
通讯作者：
Yu C