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Aortic Regurgitation III: Medical Management

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...

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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

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Published on: May 21, 2017

门节约性大动脉根置换在复星切除术的设置中.

Megan M Chung¹, Kavya Rajesh¹, Chris He²

¹Divison of Cardiovascular and Thoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY.

The Journal of thoracic and cardiovascular surgery

|January 12, 2025

概括

通过胸骨切除术进行重复性门节约性大动脉根置换 (VSRR) 是安全且持久的. 包括存活率和重新干预率在内的结果与精心挑选的患者的初级VSRR相似.

关键词:

大动脉根替代术大动脉外科手术重新启动的运行情况.门节约根部的更换

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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:

节性大动脉根置换 (VSRR) 提供了优秀的长期效果.
在需要重复手术的胸骨切割的患者中,VSRR的安全性和有效性尚未得到充分证实.
前胸骨切除术对大动脉根的手术提出了独特的挑战.

研究的目的:

评估重新手术胸腔切除术VSRR的外科安全性.
评估重复手术胸腔切除术VSRR的长期耐用性和结果.
为了比较重新操作的VSRR与初级VSRR的结果.

主要方法:

来自两个中心的778个VSRR程序 (2005-2020年) 的回顾性分析.
主要和重复手术骨切割VSRR组之间的结果比较.
使用了治疗权重的逆概率 (IPTW) 和多变量回归分析.

主要成果:

与初级VSRR (n=709) 相比,重复手术VSRR (n=69) 的急性损伤和长时间通风率更高.
再手术组的手术后死亡率略高 (2.9%对1.4%),但没有统计学意义.
在IPTW调整后,10年生存率 (82.0%) 和大动脉再干预率 (11.8%) 在两组之间是可比的.
重复手术胸骨切割并不是长期死亡率或重新干预的重要预测因素.

结论:

在选择的患者中,可以在可接受的手术死亡率下进行复手性椎切除VSRR.
在重新手术VSRR后,长期存活率和大动脉的再干预率与初级VSRR相比较.
仔细的患者选择对于成功的重复手术胸腔切除术VSRR至关重要.