Key result
Aortic root replacement using pulmonary autograft or stentless xenograft for severe aortic annular destruction resulted in 0% mortality and a 66.7% freedom from reoperation at 5 years.
Why the study?
Does aortic root replacement with pulmonary autograft or stentless xenograft improve outcomes in patients with severe aortic annular destruction due to endocarditis or aortitis?
Observational (n=9)
No
Does aortic root replacement with pulmonary autograft or stentless xenograft improve outcomes in patients with severe aortic annular destruction due to endocarditis or aortitis?
Radical exclusion of the abscess cavity and aortic root replacement using a pulmonary autograft or stentless xenograft yields excellent outcomes with no mortality in patients with severe aortic annular destruction.
May support autograft or xenograft root replacement in severe annular destruction; hypothesis-generating and requires prospective validation.
最近7年間に施行した大動脈基部手術97例のうち,9例(9.3%)に大動脈弁輪破壊を伴った.男性8例で,平均年齢は55歳であった.うち4例が活動期自己弁感染性心内膜炎であった.一方,4例に人工弁感染性心内膜炎(PVE)を認め全例が活動期であった.4例中2例は大動脈弁置換術後,2例では大動脈基部置換術後のPVEであった.残りの1例は大動脈炎に対する大動脈弁置換術後症例で人工弁の約3/4周が離脱し,心室中壁に大きな空洞を認めた.手術は膿瘍腔を有する場合には最大限にデブライドメントし,弁輪に大きな欠損部位が存在すれば心膜パッチで弁輪を再構築した.基部再建には組織に対して機械的適合性の良好な自己肺動脈グラフトやステントレス生体弁を選択し,4例にRoss手術,5例にステントレス生体弁を使用した.病院死亡,遠隔死亡は認めず,術後5年の心事故回避率は66.7%と良好な結果が得られた.
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Okada et al. (2007) conducted an observational in Severe aortic annular destruction due to destructive aortic valve endocarditis or aortitis (n=9). Aortic root replacement (pulmonary autograft or stentless xenograft) was evaluated on Mortality and freedom from reoperation at 5 years. Aortic root replacement using pulmonary autograft or stentless xenograft for severe aortic annular destruction resulted in 0% mortality and a 66.7% freedom from reoperation at 5 years.
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