罗斯手术后的自移植吐和大动脉根尺寸:德国罗斯登记处的经验
Thorsten Hanke1, Ulrich Stierle, Juergen O Boehm
1Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Germany.
Circulation
|September 14, 2007
概括
罗斯手术显示出有利的结果,最小的自移植反和大动脉根扩张. 冠心下植入技术似乎可以防止这些问题随着时间的推移.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 大动脉门维修
背景情况:
- 罗斯手术是一种复杂的心脏手术,涉及自移植植入.
- 自体移植反和大动脉根扩张是罗斯手术后的重大问题.
- 对比不同的自移植植入技术对于改善患者的治疗结果至关重要.
研究的目的:
- 为了记录罗斯手术后自移植吐和大动脉根扩张的长期发展.
- 为了比较两种不同的自移植植入技术的结果:冠心下和根部置换.
- 为了确定影响自移植完整性和大动脉根尺寸随时间推移的因素.
主要方法:
- 从德国罗斯登记处对1990年至2006年间接受罗斯手术的1014名患者进行了回顾性审查.
- 采用了两种植入技术:分冠状动脉 (n=521) 和根置换 (n=493).
- 采用分层多级建模来对连续回声心脏图数据进行统计分析,平均随访时间为4.41年.
主要成果:
- 这两种技术都显示出小型自移植吐,年进展率低.
- 冠状动脉下植入技术显示大动脉根尺寸几乎没有变化.
- 根置换技术显示,每年管结直径增加 (0.5毫米/年),而环和鼻尺寸保持稳定.
- 双主动脉形态并不总是影响根的尺寸.
结论:
- 德国罗斯注册表系列显示了罗斯手术的良好的临床和血液动力学结果.
- 自体移植反和大动脉根扩张发展缓慢,在研究的时间框架内并不显著.
- 在根部置换中,冠状动脉下技术和特定的大动脉根干预似乎可以防止自身移植的反和扩张.
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