先天性主动脉瓣二叶畸形的外科治疗

目的 总结先天性主动脉瓣二叶畸形患者的临床特点及外科治疗经验.方法 回顾性分析2008年1月-2010年12月我科行外科手术治疗的先天性主动脉瓣二叶畸形患者34例,年龄23-78(51.0±12.4)岁,其中男性28例(82.3%),女性6例(17.6%).单纯主动脉瓣狭窄10例(29.4%),主动脉瓣狭窄伴关闭不全19例(55.8%),单纯主动脉瓣关闭不全5例(14.7%).合并主动脉根部扩张30例(88.2%),合并感染性心内膜炎6例(17.6%).行单纯主动脉瓣置换术32例,行Bentall 术1例,主动脉瓣置换+ 升主动脉置换术1例.其中21例植入机械瓣,13例植入生物瓣.结果 无死亡及其他严重并发症.术后超声心动图示升主动脉内径((45.4±5.9)mm vs(40.9±6.5)mm,P<0.05)及左室舒张末内径(LVEDD)((56.9±15.5)mm vs 年44.3±9.0)mm,P<0.05)较术前明显减小.结论 先天性主动脉瓣二叶畸形合并主动脉根部扩张要根据病情行不同方式手术.

Surgical treatment of congenital bicuspid aortic valve

Objective To summarize the clinical features of congenital bicuspid aortic valve and its surgical treatment experiences.Methods Thirty-four patients with congenital bicuspid aortic valve(28 males and 6 females) at the age of 23-78 years(range 51.0±12.4 years),who underwent surgery in our department from January 2008 to December 2010,were retrospectively analyzed.Of these patients,10(29.4%) were diagnosed with pure aortic stenosis,5(14.7%) with pure aortic incompetency,19(55.8%) with aortic incompetency due to stenosis,6(17.6%) with infectious endocarditis,30(88.2%) with aortic root dilatation,32 underwent simple aortic valve replacement,1 Bentall procedure,and 1 aortic valve replacement + ascending aorta replacement.Of these patients,21 underwent mechanical valve replacement,and 12 underwent bioprosthetic valve replacement.Results No death and severe complication occurred.The ascending aortic diameter and LVEDD were smaller after operation than before operation((45.4±5.9)mm vs(40.9±6.5)mm,(56.9±15.5)mm vs(44.3±9.0)mm,P<0.05).Conclusion Congenital bicuspid aortic valve should be treated with different surgical procedures according to its condition.