目的:儿童主动脉瓣修复仍然是一个挑战。这项研究的目的是分析在我们的医疗中心使用Ozaki程序进行单小叶重建的主动脉瓣返流儿童的手术结果。
方法:对2017年5月至2019年9月接受单叶重建的9例主动脉瓣返流患儿进行了回顾性研究。使用配对t检验和Wilcoxon符号秩检验来比较不同时间点的数据。
结果:手术年龄中位数为4.7(3.5,6.4)岁。8例患者术前诊断为严重主动脉瓣反流,而其中一人有中度反流。左心室明显增大,平均z评分为3.8。在标准Ozaki程序下,使用戊二醛处理的自体心包进行单叶重建。中位随访时间为22(14,33)个月。术后无死亡或再次干预。一名患者在随访期间出现中度或更多主动脉瓣反流。主动脉瓣反流的平均程度为轻度,末次随访时左心室平均z评分降至-0.2。
结论:在我们中心,使用Ozaki手术进行单叶重建是治疗主动脉瓣反流患儿的有效手术方法,短期效果令人满意。
OBJECTIVE: Aortic valve repair in children is still a challenge. The aim of this study was to analyse the surgical results of children with aortic regurgitation who underwent single leaflet reconstruction using the Ozaki procedure in our medical centre.
METHODS: A retrospective study was conducted of nine children with aortic regurgitation who received single leaflet reconstruction from May 2017 to September 2019. Paired t-tests and Wilcoxon signed rank tests were used to compare the data at different time points.
RESULTS: The median surgical age was 4.7 (3.5, 6.4) years. Eight patients were pre-operatively diagnosed with severe aortic regurgitation, while one had moderate regurgitation. The left ventricles were significantly enlarged, with an average z-score of 3.8. Single leaflet reconstruction was carried out using glutaraldehyde-treated autologous pericardium under the standard Ozaki procedure. The median follow-up was 22 (14, 33) months. There was no post-operative death or re-intervention. One patient had moderate or more aortic regurgitation during the follow-up. The average degree of aortic regurgitation was mild, and the average z-score of the left ventricle decreased to -0.2 in the last follow-up.
CONCLUSIONS: Single leaflet reconstruction using the Ozaki procedure was an effective surgical method for treating children with aortic regurgitation in our centre with satisfactory short-term results.