大动脉根的重塑 - 一个28年的旅程
Karen B Abeln1, Tristan Ehrlich1, Lennart Froede1
1Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany.
Annals of cardiothoracic surgery
|June 12, 2023
概括
根改造是对大动脉问题的可行的门保护手术. 这项为期28年的审查显示了良好的长期结果,具有很高的免于重新操作的自由度,特别是在三主动脉上.
科学领域:
- 心血管外科心血管外科
- 大动脉门外科手术
- 大动脉根的重建
背景情况:
- 根改造是对大动脉吐和动脉瘤的一种门保护技术.
- 这篇评论总结了28年的根改造经验.
研究的目的:
- 在一大群患者中评估根改造的长期结果.
- 评估门形态和手术修改对结果的影响.
主要方法:
- 在1,189名患者 (1995-2022) 中进行了根改造.
- 分析包括形状学,顶修复和使用外部 suture annuloplasty.
- 平均随访时间为6.7年 (95%完成).
主要成果:
- 20年生存率为71%;无心脏病死亡率为80%.
- 在15年内,从显著的大动脉吐的自由度为77%.
- 15年无需重新手术的自由度为89%,在三管 (94%) 与双管 (84%) 和单管 (P<0.001) 中更高.
结论:
- 根改造是门保护性大动脉根置换的可行选择.
- 在外科手术期间有效的高度测量有助于纠正凸.
- 同时进行无效塑造术的长期益处需要进一步定义.
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