■作为主动脉瓣疾病的外科治疗选择,自体心包的主动脉瓣新穿孔越来越受到关注。然而,对中期耐久性和瓣膜相关事件知之甚少。
■在2016年至2021年期间接受主动脉瓣新膀胱术的患者被包括在内。术前进行经胸超声心动图检查,在放电时,此后每年。数据分析了结构瓣膜劣化的发生率,生物人工瓣膜衰竭,生存,不再操作,和血液动力学性能。
■共有162例患者接受了主动脉瓣新肠切开术(平均年龄,52.6±16.6年;范围,13-78岁);男性为114(70.4%)。共有132例患者出现二叶主动脉瓣(81.5%)和126例患者出现主动脉瓣狭窄(77.8%)。63例患者(38.9%)同时进行手术。平均随访时间为3.5±1.2年。出院时,峰值和平均压力梯度分别为15.6±7.2mmHg和8.4±3.7mmHg,分别,平均有效孔口面积为2.4±0.8cm2。五年后,峰值和平均压力梯度分别为14.5±4.6mmHg和7.5±2.2mmHg,分别,平均有效孔口面积为2.3±0.8cm2。在5年,中度和重度结构性瓣膜恶化和生物瓣膜衰竭的累积发生率为9.82%±3.87%,6.96%±3.71%,和12.1%±4.12%,分别。生存率为97.3%±1.4%,再次手术的自由度为91.3%±2.4%。
■主动脉瓣新张合术在初次手术后早期和随访期间实现低压力梯度。在这个年轻的患者群体中,存活率非常高。再次手术的主要原因是心内膜炎,结构性瓣膜变性的发生率很低。
UNASSIGNED: Aortic valve neocuspidization with autologous pericardium is gaining increasing attention as a surgical treatment option for aortic valve disease. However, little is known about midterm durability and valve-related events.
UNASSIGNED: Patients undergoing aortic valve neocuspidization between 2016 and 2021 were included. Transthoracic echocardiography was performed before the operation, at discharge, and annually thereafter. Data were analyzed for incidences of structural valve deterioration, bioprosthetic valve failure, survival, freedom from reoperation, and hemodynamic performance.
UNASSIGNED: A total of 162 patients underwent aortic valve neocuspidization (mean age, 52.6 ± 16.6 years; range, 13-78 years); 114 (70.4%) were male. A total of 132 patients presented with a bicuspid aortic valve (81.5%) and 126 patients presented with aortic valve stenosis (77.8%). Concomitant procedures were performed in 63 patients (38.9%). Mean follow-up was 3.5 ± 1.2 years. At discharge, peak and mean pressure gradients were 15.6 ± 7.2 mm Hg and 8.4 ± 3.7 mm Hg, respectively, with a mean effective orifice area of 2.4 ± 0.8 cm2. After 5 years, peak and mean pressure gradients were 14.5 ± 4.6 mm Hg and 7.5 ± 2.2 mm Hg, respectively, with a mean effective orifice area of 2.3 ± 0.8 cm2. At 5 years, cumulative incidences of moderate and severe structural valve deterioration and bioprosthetic valve failure were 9.82% ± 3.87%, 6.96% ± 3.71%, and 12.1% ± 4.12%, respectively. Survival was 97.3% ± 1.4%, and freedom from reoperation was 91.3% ± 2.4%.
UNASSIGNED: Aortic valve neocuspidization accomplishes low pressure gradients early after initial surgery and during follow-up. Survival in this young patient population is excellent. The main reason for reoperation is endocarditis, and rates for structural valve degeneration are low.