接受手术的二瓣化和三瓣化主动脉瓣患者的临床差异

目的研究需要接受主动脉瓣膜或者升主动脉手术的二瓣化或者三瓣化主动脉瓣膜患者的临床差异.方法将1996-2001年的2 570例主动脉瓣膜病变患者,根据主动脉瓣膜形态分为二组,2 015例(78.4%)是三瓣化瓣膜,555例(21.6%)是二瓣化主动脉瓣膜,具体研究统计各项相关数据.结果男性患者在二组中均明显多于女性,在二瓣化组中尤其明显.在二组中早期导致手术的瓣膜病变均是瓣膜狭窄.二瓣化瓣膜的患者接受主动脉瓣膜或者升主动脉手术的年龄平均比三瓣化瓣膜的患者年轻10岁.在二瓣化患者中的升主动脉扩张的发生率明显高于三瓣化的患者.但是在A型主动脉夹层动脉瘤的患者中,三瓣化瓣膜明显比二瓣化瓣膜多.三瓣化主动脉瓣膜的患者同时接受冠状动脉搭桥手术的概率明显高于二瓣化的患者.结论经临床资料对比显示,主动脉瓣先天性二瓣化畸形会加速瓣膜自身的纤维化、钙化导致瓣膜狭窄和关闭不全的早期出现,并且增加升主动脉扩张的危险性.

MANIFESTATION DIFFERENCES OF PATIENTS WITH BICUSPID AND TRIC USPID AORTIC VALVE

Objective To study the different clinic symptoms of patients with bicuspid or tricuspid aortic valve who need to be operated on aortic valve or ascending aorta. Methods 2570 patients with aortic valve or Aorta ascending illness from 1996 to 2001 were divided into two groups according to their aortic valve forms. Among them 2015 cases (78.4%) were with tricuspid aortic valve, and 555 cases (21.6%) were with bicuspid aortic valve. Detailed statistics were studied. Results The number of male patients in both groups was evidently larger than that of female patients, especially in the group with bicuspid aortic valve. The common reason for early operation s in both groups was valve stenosis. Bicuspid aortic valve patients who received aortic valve or aorta ascending operations were on average 10 years younger than the tricuspid aortic valve patients. The dilatation of ascending aorta in bicuspid valve group was obviously higher than that in tricuspid valve group. But for Type A dissection patients, those in tricuspid valve group were obviously higher than those in bicuspid valve group. The probability of tricuspid valve patients receiving also coronary arteries bypass graft was higher than that of bicuspid valve patients. Conclusion Congenital bicuspid aortic valve accelerates the appearance of valve fibrosis, calcify leading to valve stenosis and insufficient. In addition, it increases the risk of descending aorta dilatation.