Ascending aortic dilatation combined with aortic valve disease: ascending aortic replacement or aortoplasty
10.3760/cma.j.issn.1001-4497.2010.04.008
- VernacularTitle:升主动脉置换术或成形术治疗主动脉瓣病变合并的升主动脉瘤样扩张
- Author:
Zhiyun XU
;
Fanglin LU
;
Lin HAN
;
Liangjian ZOU
;
Baoren ZHANG
;
Zhigang SONG
;
Xilong LANG
;
Jibin XU
- Publication Type:Journal Article
- Keywords:
Aortic aneurysm,thoracic Blood vessel prosthesis;
Cardiac surgical procedures;
Aortic replacement,Aortic;
Aortoplasty
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2010;26(4):236-239
- CountryChina
- Language:Chinese
-
Abstract:
Objective The results of Aortic valve replacement (AVR). Combined with ascending aortic replacement(group A) or aortoplasty (group B) in patients with aortic valve disease and ascending aortic dilatation were analysed to assess the clinical outcomes and respective indications. Methods Among the two groups, the age, gender, NYHA class, types of aortic valve lesions and left ventricular ejection fraction were not different statically. The ascending aortic diameters in group A[(50.41 ±3.71) mm] and group B [(48.29±2.18) mm] were not statically different. Ascending aortic replacement was performed in Group A. A Dacron tube(diameter 28 ～ 30mm) was routinely wrapped around the ascending aorta after aortoplasty in group B. Results There was 1 postoperative death in group B, blood transfusion volume and postoperative complications were not stasticaly different in the two groups. Cardiopulmonary bypass time [(110.52 ± 27.51) min] and aortic across clumping time [(71.70 ± 17.13)min] in group A were significantly longer than that of group B [(97.31 ± 19.46) min,P=0. 004; (57.13 ±19.46) min, respectively. P=0.025]. Conclusion Aortic valve disease, especially bicuspid valve disease often combines with ascending aortic dilatation or aneurysm. In younger patients, ascending aorta should be actively treated surgically when the diameter is equal or more than 40mm. Aortoplasty with external reinforcement of a Dacron tube is simpler and safer than aortic replacement in patient without aortic atherosclerosis or ulceration, and large aneurysm.
