Lifetime Management of Adolescents and Young Adults with Congenital Aortic Valve Disease.

IF 3.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Thoracic Surgery Pub Date : 2025-01-01 Epub Date: 2024-06-11 DOI:10.1016/j.athoracsur.2024.04.038
William C Frankel, Justin A Robinson, Eric E Roselli, Shinya Unai, Justin T Tretter, Stephanie Fuller, Jennifer S Nelson, Joanna Ghobrial, Lars G Svensson, Gösta B Pettersson, Hani K Najm, Tara Karamlou
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引用次数: 0

Abstract

In this invited expert review, we focus on evolving lifetime management strategies for adolescents and young adults with congenital aortic valve disease, acknowledging that these patients often require multiple interventions during their lifetime. Our goal is to preserve the native aortic valve when feasible. Leveraging advanced multimodality imaging, a detailed assessment of the aortic valve and root complex can be obtained, and a surgically approach tailored to an individual patient's anatomy and pathology can be used. In turn, aortic valve repair and reconstruction can be offered to a greater number of patients, either as a definitive strategy or as a component of a staged strategy to delay the need for aortic valve replacement until later in life when more options are available.

Abstract Image

对患有先天性主动脉瓣疾病的青少年的终生管理。
在这篇特邀专家综述中,我们将重点关注患有先天性主动脉瓣疾病的青少年和年轻成人的终生管理策略的演变,因为我们认识到这些患者在其一生中往往需要多次介入治疗。我们的目标是在可行的情况下保留原生主动脉瓣。利用先进的多模态成像技术,可以对主动脉瓣和瓣根复合体进行详细评估,并根据患者的解剖结构和病理情况量身定制手术方法。反过来,主动脉瓣修复和重建也可以作为一种明确的策略或分阶段策略的一部分提供给更多的患者,将主动脉瓣置换的需要推迟到晚年,因为晚年有更多的选择。对于患有无法修复的主动脉瓣疾病的青少年和年轻人,我们的首选策略是用肺自体移植(Ross 手术)或自体心包(Ozaki 手术)进行主动脉瓣置换。使用生物人工瓣膜或机械瓣膜进行主动脉瓣置换术是一种安全、可重复的选择,是青少年和年轻成人的 "最后手段",因为瓣膜相关并发症的终生累积风险以及这些患者在随访期间的持续流失。
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来源期刊
Annals of Thoracic Surgery
Annals of Thoracic Surgery 医学-呼吸系统
CiteScore
6.40
自引率
13.00%
发文量
1235
审稿时长
42 days
期刊介绍: The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. The Annals of Thoracic Surgery features: • Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques • New Technology articles • Case reports • "How-to-do-it" features • Reviews of current literature • Supplements on symposia • Commentary pieces and correspondence • CME • Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery. An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.
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