ロス手術後,大動脈の根の運命
Giovanni Battista Luciani1, Gianluca Casali, Alessandro Favaro
1Division of Cardiac Surgery, University of Verona, Italy. gbluciani@yahoo.com
Circulation
|September 13, 2003
まとめ
自動移植の拡張は,特に若い患者において,ロス手術後に一般的です. これは自動移植弁の機能不全につながる可能性がありますが,再手術はまれです.
科学分野:
- 心血管外科手術についてです.
- 胸部外科手術について
- 心臓外科手術について
背景:
- ロス手術は,若い患者におけるメカニカル大動脈弁置換術の代替手段です.
- ロス手術後の早期の肺自動移植の根の膨張が観察されています.
- この研究では,遅期のオートグラフトの膨張,その危険因子,そしてその結果について調査しています.
研究 の 目的:
- ロス手術の後の遅い自己移植の拡張の有病率を判断する.
- オートグラフトの膨張に関連する危険因子を特定するために.
- バルブ機能と再稼働率に対するオートグラフト膨張の影響を評価する.
主な方法:
- 1994年5月から連続してロス手術を受けたすべての患者のレビュー.
- 臨床検査とエコーカルディオグラフィー検査は,少なくとも1年間のフォローアップを伴う患者に対して行われます.
- 予測要因を特定するためのコックス比例危険性分析を含む統計分析.
主要な成果:
- 自体移植後の拡張は34%の患者で確認されました.
- 年齢の若さ,Valsalvaの術前鼻腔,根の置換技術,心臓の裏付けの欠如は,膨張を予測しています.
- 自体移植の反発は,患者の14%で発生し,拡張性のある患者ではより一般的でした.
結論:
- 自動移植の膨張は,ロス手術後遅くに,特に若い患者および手術前の大動脈動脈瘤を患っている患者で一般的です.
- 二動脈弁は膨張の危険因子ではありません.
- 重要な自己移植弁機能不全は,自己移植弁の膨張を有する患者でより一般的です.
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