PDF(Pubmed)
Abstract：
UNASSIGNED: Among patients with bicuspid aortic valves (BAV) who are potential candidates for valve-sparing root replacement (VSRR), the long-term durability of this technique is not well understood. This study aimed to compare the clinical and echocardiographic outcomes of VSRR in those with BAV and tricuspid aortic valve (TAV) morphology.
UNASSIGNED: This was a retrospective analysis of patients who underwent VSRR between 2007 and 2021 at a single center. Kaplan-Meier and log-rank analysis were used to estimate and compare freedom from mortality, progression to >2+ aortic insufficiency (AI), and reoperation between groups (BAV vs TAV). Preoperative and postoperative echocardiographic data were collected and assessed for temporal changes in mixed-effect models.
UNASSIGNED: A total of 185 patients (BAV, n = 52, 28.1%; TAV, n = 133, 71.9%) underwent VSRR. At baseline, BAV patients were younger (42.4 ± 11.6 vs 52.3 ± 12.6 years; P < 0.01) and had more severe AI (47.9% vs 27.0%; P = 0.02). Average cardiopulmonary bypass and cross-clamp times were similar. There were no differences in rates of postoperative complications, intensive care unit or hospital days, or 30-day readmission. TAV patients\' 1-, 5-, and 8-year survival rates were 99.2% [95% CI 97.8-100], 96.7% [93.5-99.9%], and 92.2% [85.6-99.3%], respectively. Overall, there were no differences between groups regarding freedom from mortality (P = 0.18), reoperation (P = 0.51), or recurrent >2+ AI (P = 0.97). .
UNASSIGNED: VSRR can be safely performed on patients with BAV and TAV morphology, yielding similar midterm freedom from mortality, recurrent >2+ AI, and reoperation. This technique should be considered in carefully selected patients with aortic root pathology and BAV anatomy when performed at experienced centers.
UNASSIGNED: This was a retrospective analysis of patients who underwent VSRR between 2007 and 2021 at a single center. Kaplan-Meier and log-rank analysis were used to estimate and compare freedom from mortality, progression to >2+ aortic insufficiency (AI), and reoperation between groups (BAV vs TAV). Preoperative and postoperative echocardiographic data were collected and assessed for temporal changes in mixed-effect models.
UNASSIGNED: A total of 185 patients (BAV, n = 52, 28.1%; TAV, n = 133, 71.9%) underwent VSRR. At baseline, BAV patients were younger (42.4 ± 11.6 vs 52.3 ± 12.6 years; P < 0.01) and had more severe AI (47.9% vs 27.0%; P = 0.02). Average cardiopulmonary bypass and cross-clamp times were similar. There were no differences in rates of postoperative complications, intensive care unit or hospital days, or 30-day readmission. TAV patients\' 1-, 5-, and 8-year survival rates were 99.2% [95% CI 97.8-100], 96.7% [93.5-99.9%], and 92.2% [85.6-99.3%], respectively. Overall, there were no differences between groups regarding freedom from mortality (P = 0.18), reoperation (P = 0.51), or recurrent >2+ AI (P = 0.97). .
UNASSIGNED: VSRR can be safely performed on patients with BAV and TAV morphology, yielding similar midterm freedom from mortality, recurrent >2+ AI, and reoperation. This technique should be considered in carefully selected patients with aortic root pathology and BAV anatomy when performed at experienced centers.
摘要：
■在保留瓣膜根部置换（VSRR）的二叶主动脉瓣（BAV）患者中，这种技术的长期耐久性还没有得到很好的理解。这项研究旨在比较BAV和三尖瓣主动脉瓣（TAV）形态的VSRR的临床和超声心动图结果。
■这是对2007年至2021年在单个中心接受VSRR的患者的回顾性分析。Kaplan-Meier和log-rank分析用于估计和比较无死亡率，进展为>2+主动脉瓣关闭不全（AI），组间再手术（BAVvsTAV）。收集术前和术后超声心动图数据，并评估混合效应模型中的时间变化。
■总共185名患者（BAV，n=52,28.1%;TAV,n=133，71.9%)接受VSRR。在基线,BAV患者年龄较小（42.4±11.6vs52.3±12.6岁；P<0.01），AI更严重（47.9％vs27.0％；P=0.02）。平均体外循环和交叉钳夹时间相似。术后并发症发生率无差异，重症监护病房或住院天数，或重新接纳30天。TAV患者\'1-，5-,8年生存率为99.2%[95%CI97.8-100]，96.7%[93.5-99.9%]，和92.2%[85.6-99.3%]，分别。总的来说,在无死亡率方面，组间没有差异(P=0.18)，再手术（P=0.51），或复发>2+AI（P=0.97）。.
■VSRR可以安全地对具有BAV和TAV形态的患者进行，产生类似的中期死亡率自由，递归>2+AI，再操作。在经验丰富的中心进行时，应在精心选择的主动脉根部病理学和BAV解剖结构的患者中考虑此技术。
■这是对2007年至2021年在单个中心接受VSRR的患者的回顾性分析。Kaplan-Meier和log-rank分析用于估计和比较无死亡率，进展为>2+主动脉瓣关闭不全（AI），组间再手术（BAVvsTAV）。收集术前和术后超声心动图数据，并评估混合效应模型中的时间变化。
■总共185名患者（BAV，n=52,28.1%;TAV,n=133，71.9%)接受VSRR。在基线,BAV患者年龄较小（42.4±11.6vs52.3±12.6岁；P<0.01），AI更严重（47.9％vs27.0％；P=0.02）。平均体外循环和交叉钳夹时间相似。术后并发症发生率无差异，重症监护病房或住院天数，或重新接纳30天。TAV患者\'1-，5-,8年生存率为99.2%[95%CI97.8-100]，96.7%[93.5-99.9%]，和92.2%[85.6-99.3%]，分别。总的来说,在无死亡率方面，组间没有差异(P=0.18)，再手术（P=0.51），或复发>2+AI（P=0.97）。.
■VSRR可以安全地对具有BAV和TAV形态的患者进行，产生类似的中期死亡率自由，递归>2+AI，再操作。在经验丰富的中心进行时，应在精心选择的主动脉根部病理学和BAV解剖结构的患者中考虑此技术。
