Should the ascending aorta be replaced more frequently in patients with bicuspid aortic valve disease?
Should the ascending aorta be replaced more frequently in patients with bicuspid aortic valve disease?
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DOI：
10.1016/j.jtcvs.2004.07.009
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发表时间：
2004-11-01
影响因子：
6
通讯作者：
David, TE
中科院分区：
文献类型：
--
作者：
Borger, MA;Preston, M;David, TE
目的：升主动脉置换术的最佳直径应在bicuspid主动脉瓣diseases.Methods：我们回顾了所有患者的bicuspid主动脉瓣进行主动脉瓣置换术在我们的机构从1979年至1993年（n = 201）。结果：98%的患者获得随访，为10.3 +/- 3.8（平均+/- SID）年。患者平均年龄为56 ± 15岁，76%为男性。升主动脉正常（5.0 cm），接受了升主动脉置换术，因此被排除。15年生存率为67%。在随访期间，44例患者需要再次手术，主要是因为人工主动脉瓣失败。22名患者发生了与升主动脉相关的长期并发症：18名患者需要手术置换升主动脉（治疗主动脉瘤），1名患者发生了主动脉夹层，3名患者发生了心源性猝死。主动脉直径小于4.0 cm、4.0 ~ 4.4 cm和4.5 ~ 4.9 cm的患者15年无升主动脉相关并发症的比例分别为86%、81%和43%（P
Objective: The optimal diameter at which replacement of the ascending aorta should be performed in patients with bicuspid aortic valve disease is not known.Methods: We reviewed all patients with bicuspid aortic valves undergoing aortic valve replacement at our institution from 1979 through 1993 (n = 201). Patients undergoing concomitant replacement of the ascending aorta were excluded.Results: Follow-up was obtained on 98% of patients and was 10.3 +/- 3.8 (mean +/- SID) years. The average patient age was 56 +/- 15 years, and 76% were mate. The ascending aorta was normal (5.0 cm) underwent replacement of the ascending aorta and were therefore excluded. Fifteen-year survival was 67%. During follow-up, 44 patients required reoperation, predominantly for aortic valve prosthesis failure. Twenty-two patients had long-term complications related to the ascending aorta: 18 required an operative procedure to replace the ascending aorta (for aortic aneurysm), I had aortic dissection, and 3 experienced sudden cardiac death. Fifteen-year freedom from ascending aorta-related complications was 86%, 81%, and 43% in patients with an aortic diameter of less than 4.0 cm, 4.0 to 4.4 cm, and 4.5 to 4.9 cm, respectively (P