经典Ross术后自体肺扩张及其危险因素的回顾性单中心研究

I. Chernov, S. Enginoev, S. Ekimov, T. K. Rashidova, U. K. Abdulmedzhidova, M. A. Guliyev, A. Ziankou, A. Gamzaev
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引用次数: 0

摘要

介绍自体肺移植主动脉瓣置换术(Ross手术)显示出良好的近期和长期效果。自体肺移植物的长期扩张是重复手术的主要原因。目的:探讨自体肺移植扩张的发生率及其危险因素。材料和方法。从2009年4月到2022年12月,158名患者接受了经典的罗斯手术。纳入标准:年龄在18岁及以上的患者,接受经典手术的患者。排除标准:18岁以下患者,改良罗斯手术方法。随访时间:104(49-124)个月。结果和讨论。患者的中位年龄为33(25-43)岁。住院死亡率占0.6%。围手术期心肌损伤占3.8%,需要植入永久性起搏器的传导障碍占1.9%,需要血液透析的中风和急性肾损伤的发生率为0.6%。10年无自体移植物再次手术88.4例。主动脉瘤10年无再手术发生率为92%。长期预测自体移植物扩张的因素是:年龄(OR:0.942;95%CI:0.901-0.984,p=0.008)和瓦尔萨尔瓦窦的初始大小(OR:1.18;95%CI:1.027-1.215,p=0.001)。结论。10年内因主动脉扩张而再次进行自体移植物移植的自由度和主动脉扩张≥45mm的自由度分别为92%和37.2%。术后自体移植物扩张的主要预测因素是瓦尔萨尔瓦窦的年龄和初始直径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pulmonary Autograft Dilatation and its Risk Factors After Classical Ross Procedure: a Retrospective Single Center Study
   Introduction. Aortic valve replacement with pulmonary autograft (Ross procedure) demonstrated excellent immediate and long-term results. Dilation of the pulmonary autograft in the long-term period is the main reason for repeated surgery. Aim: to study the prevalence of pulmonary autograft dilatation and its risk factors.   Materials and methods. From April 2009 to December 2022, 158 patients underwent classical Ross surgery. Inclusion criteria: patients aged 18 and older, patients who underwent classical surgery. Exclusion criteria: patients under 18, modifi ed methods of Ross procedure. Follow-up period: 104 (49–124) months.   Results and discussion. The median age of patients was 33 (25–43) years. Hospital mortality accounted for 0.6 %. Perioperative myocardial injury was 3.8 %, conduction disorder requiring permanent pacemaker implantation accounted for 1.9 %, the incidence of strokes and acute kidney injury requiring hemodialysis was 0.6 %. Ten-year freedom from autograft reoperation was 88.4. Ten-year freedom from reoperation for aortic aneurysm accounted for 92 %. Predictors of autograft dilatation in the long-term period were: age (OR: 0.942; 95% CI: 0.901–0.984, p = 0.008) and the initial size of sinuses of Valsalva (OR: 1.18; 95% CI: 1.027–1.215, p = 0.01).   Conclusion. Ten-year freedom from autograft reoperation due to aortic dilatation and freedom from aortic dilatation ≥ 45 mm was 92 % and 37.2 %, respectively. The main predictors of autograft dilatation in the postoperative period are the age and the initial diameter of the sinuses of Valsalva.
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