在双管与三管主动脉疾病的亚冠状动脉罗斯手术后,主动脉功能和根尺寸的时间过程
C Schmidtke1, M Bechtel, M Hueppe
1Department of Cardiac Surgery, Medical University of Luebeck, Luebeck, Germany. schmidtk@medinf.mu-luebeck.de
Circulation
|September 25, 2001
概括
肺下冠状动脉自移植技术在双主动脉疾病患者中显示出优异的功能和稳定的大动脉根尺寸,与三主动脉疾病相比,直至手术后5.5年.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 大动脉门维修
背景情况:
- 独立的大动脉根肺自体移植是首选的,但可能会扩张,导致大动脉功能不充分.
- 关于双主动脉疾病的最佳手术技术存在争议.
- 有限的数据比较双管与三管主动脉的亚冠状动脉技术结果.
研究的目的:
- 评估冠状动脉下肺自移植技术的长期功能和大动脉根尺寸.
- 为了比较先天性双主动脉病患者与获得的三主动脉病患者的结果.
主要方法:
- 对31名双主动脉患者 (A组) 和51名三主动脉患者 (B组) 的心声随访.
- 患者在1994年6月至1998年8月期间接受了手术.
- 收集的数据包括两个术后时间点的压力梯度,大动脉缺陷分级和大动脉根尺寸.
主要成果:
- 双体和三体组之间压力梯度或大动脉缺陷没有显著差异.
- 大动脉功能不全在大多数患者中仍然是亚临床的,随着时间的推移略有增加的趋势 (38%).
- 大动脉根尺寸稳定,在随访期间,各组之间没有差异.
结论:
- 冠肺下肺部自体移植在双管主动脉疾病中表现出卓越和稳定的功能.
- 结果与三主动脉病患者在术后5.5年观察到的结果相似.
- 亚冠状动脉技术需要重新考虑肺部自体移植,特别是在双主动脉疾病中.
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