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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

真正的重复大动脉根置换与之前任何手术后的根置换相比.

Parth M Patel¹, Dov Levine², Andy Dong¹

¹Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Ga.

|January 11, 2024

概括

重生性大动脉根置换 (redo-ROOT) 的结果非常出色. 之前的大动脉根置换 (True-Redo) 与之前的任何手术 (Any-Redo) 显示了类似的住院死亡率,但改善了True-Redo的中期存活率.

关键词:

大动脉根替代术大动脉外科手术大动脉门的大动脉门重新启动的运行情况.

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科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
大动脉外科手术

背景情况:

之前的大动脉根置换 (True-Redo) 与任何之前的手术 (Any-Redo) 对重新手术大动脉根置换 (redo-ROOT) 后的结果的临床影响仍然在很大程度上未知.
这项多机构研究解决了这一差距,比较了接受重复ROOT的患者的结果.

研究的目的:

为了比较经过前一次大动脉根置换 (True-Redo) 患者的重复性大动脉根置换 (redo-ROOT) 的临床结果与任何之前手术 (Any-Redo) 患者的临床结果.
在接受重复ROOT的患者中识别死亡风险因素.

主要方法:

在2004年至2021年期间接受了重复ROOT的822名患者的多机构回顾性审查.
通过对比True-Redo (n=184) 和Any-Redo (n=638) 组,根据手术前的人口统计和并发手术创建了174对匹配对.
对早期和晚期死亡进行了独立的风险因素分析.

主要成果:

真正的Redo患者比较年轻 (49.9岁对55.3岁).
住院死亡率相似 (两组均为13%).
在4年的中期生存分析显示,True-Redo组的结果有所改善 (P=0.046),尽管绕道和交叉时间更长. 年龄较大,射出率较低和男性性别是住院死亡的风险因素.

结论:

在重复ROOT后的临床结果非常出色.
在先前的大动脉根置换 (True-Redo) 后进行 redo-ROOT 不会使住院发病率或死亡率恶化,并且与 Any-Redo 组相比,提供更好的中期存活率.
个性化患者评估对于 redo-ROOT 程序的最佳结果至关重要.