背景:法洛四联症是最常见的紫癜性CHD。随着先进手术方法的出现,大多数法洛四联症患者达到成年。然而,许多人需要对残余的异常进行再干预,包括残余的右心室流出道梗阻,肺反流,残余室间隔缺损,和进行性主动脉扩张。主动脉扩张可能导致主动脉瓣返流或需要手术矫正的夹层。在目前的研究中,我们的目的是在我们的三级护理中心确定成人法洛四联症修复后主动脉根部扩张的患病率和结局.
方法:在这项回顾性研究中,包括730例具有法洛四联症修复史的连续患者。瓣环水平的主动脉直径,Valsalva的窦,窦管交界处,和通过超声心动图测量的升主动脉进行评估。记录了需要重新干预的结果的患病率,包括主动脉瓣反流和夹层。
结果:环的平均大小,Valsalva窦,窦管连接处,而升主动脉在最新可用的超声心动图检查中的患者为2.4+/-0.4cm,3.3+/-0.5厘米,2.9+/-0.5cm,和3.2+/-0.5厘米,分别。Valsalva窦扩张的患病率,升主动脉扩张,窦管连接处,主动脉瓣环为28.7%,21%,8.3%,1%,分别。5例患者发生严重的主动脉瓣反流(0.6%)并接受了手术修复。其中一名患者出现急性主动脉夹层。
结论:主动脉扩张在法洛四联症中很常见,但主动脉扩张的重做手术的患病率,返流,包括急性夹层在内的不良事件较低。
BACKGROUND: Tetralogy of Fallot is the most prevalent cyanotic
CHD. With the advent of advanced surgical methods, the majority of tetralogy of Fallot patients reach adulthood. However, many need re-intervention for the residual anomalies including residual right ventricular outflow obstruction, pulmonary regurgitation, residual ventricular septal defects, and progressive aortic dilatation. Aortic dilation could lead to aortic regurgitation or dissection requiring surgical correction. In the current
study, we aimed to determine the prevalence and outcomes of aortic root dilatation in adults with repaired tetralogy of Fallot in our tertiary care centre.
METHODS: In this retrospective
study, 730 consecutive patients with history of repaired tetralogy of Fallot were included. Aortic diameter at the level of annulus, the sinus of Valsalva, sinotubular junction, and the ascending aorta as measured by echocardiography were evaluated. Prevalence of outcomes necessitating re-intervention including aortic regurgitation and dissection were recorded.
RESULTS: The mean size of annulus, sinus of Valsalva, sinotubular-junction, and ascending aorta in the latest available echocardiography of patients were 2.4+/-0.4 cm, 3.3+/-0.5 cm, 2.9+/-0.5cm, and 3.2+/-0.5cm, respectively. Prevalence of dilatation of sinus of Valsalva, dilation of Ascending aorta, sinotubular-junction, and aortic annulus was 28.7%, 21%, 8.3%, and 1 %, respectively. Five patients had severe aortic regurgitation (0.6%) and underwent surgical repair. One of these patients presented with acute aortic dissection.
CONCLUSIONS: Aortic dilation is common in tetralogy of Fallot but prevalence of redo surgery for aortic dilation, regurgitation, and adverse events including acute dissection is low.