Analysis of clinical effect of aortic valve replacement with enlarged root of small aortic annulus
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摘要: 目的：探讨主动脉瓣膜置换术前先行主动脉瓣环根部扩大手术的早、中期疗效及生活质量情况。方法：回顾性分析2014-03-2018-03在贵州省人民医院接受经小主动脉瓣环根部加宽的主动脉瓣置换术的30例患者临床资料。采用中文版SF-36量表评估其手术前后1年的生活质量变化情况。结果：30例患者未见手术和住院死亡的发生。术后2周复查心脏彩超显示，左室射血分数、室间隔厚度、跨主动脉瓣峰值压差、跨瓣平均压差降低。左室后壁厚度和有效瓣口面积指数明显增加。术后1年复查心脏彩超显示，左室射血分数增加，室间隔厚度和左室后壁厚度明显降低，左心室重构的相关指标和血流动力学的指标较前改善。手术前后1年患者的生活质量变化情况：生理功能（PF）、生理职能（RP）、总体健康（GH）、活力（VT）和社会职能（SF）5个方面差异有统计学意义（P<0.05）。结论：细小主动脉瓣环根部加宽主动脉瓣置换术的患者近中期效果良好，术后心脏结构和功能大多能恢复正常，患者的生活质量改善。Abstract: Objective: To investigate the early and mid-term clinical effect and quality of life in aortic annular root enlargement before aortic valve replacement.Method: Clinical data of 30 patients with aortic valve disease who underwent aortic valve replacement with small aortic ring widening in Guizhou People's Hospital, between Mar.2014 and Mar.2018, were retrospectively analyzed.The quality of life of 30 patients before and after operation was evaluated with the Chinese version of SF-36 scale.Result: There was no operative and hospitalization death occurred in all of the 30 cases with small aortic root through the aortic annulus enlargement artificial aortic valve replacement surgery.After 2 weeks, the heart color sonography showed that LVEF, IVS, TAVPPG and MVPG were decreased obviously.LVPW and BSA were increased significantly.After 1 year, LVEF was significantly improved.IVS and LVPW were obviously decreased.The indexes of hemodynamics and left ventricular remodeling parameters were significantly improved.The quality of life of patients before and after operation was evaluated with SF-36 scale.There were significant differences in five aspects:physiological function, general health, vitality and social function (P<0.05).Conclusion: Aortic valve replacement with widening the root of small aortic annulus can be performed with good early and mid-term outcomes in patient.
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