主动脉成形术治疗主动脉瓣病变伴升主动脉扩张的疗效分析

目的总结主动脉成形术治疗主动脉瓣病变伴升主动脉扩张患者的临床经验及疗效。方法1998年2月至2004年5月共对23例主动脉瓣病变伴升主动脉扩张的患者行主动脉瓣膜置换和纵行切除部分升主动脉壁的主动脉成形术,术后随访4～78个月,平均(36±25)个月,分别于术前、术后出院前及术后随访中,通过心脏超声检查测量主动脉直径。结果主动脉直径术前为(4.8±0.5)cm,术后出院前为(3.6±0.4)cm,两者比较差异有统计学意义(P<0.01)。术后随访中,主动脉直径为(3.7±0.4)cm,与术前比较差异有统计学意义(P<0.01),与术后出院前比较差异无统计学意义(P>0.05)。结论应用切除部分升主动脉壁的主动脉成形术治疗主动脉瓣病变伴升主动脉扩张或升主动脉瘤,中期疗效良好。

Reduction aortoplasty for dilatation of the ascending aorta in patients with aortic valve disease

OBJECTIVE: To evaluate the effect of reduction aortoplasty for dilatation of the ascending aorta in patients with aortic valve disease. METHODS: Between February 1998 and May 2004, 23 patients with aortic valve disease and dilatation of the ascending aorta underwent reduction aortoplasty in combination with aortic valve replacement. The diameter of the ascending aorta was measured before and early after surgery and then later between 4 and 78 months [mean (36 +/- 25) months] postoperatively using echocardiography. RESULTS: The reduction aortoplasty decreased the diameter of the aorta from (4.8 +/- 0.5) cm preoperatively to (3.6 +/- 0.4) cm early after surgery (P < 0.01). During follow-up, the diameter of aorta increased from (3.6 +/- 0.4) cm early after surgery to (3.7 +/- 0.4) cm after a mean follow-up of (36 +/- 25) months (P < 0.05). CONCLUSION: Reduction aortoplasty shows good mid-term results in patients with aortic valve disease and dilatation of the ascending aorta. Long-term results need to be followed up.