Kết quả sớm phẫu thuật tái tạo van động mạch chủ hai lá van bằn màng ngoài tim tự thân
Nội dung chính của bài viết
Tóm tắt
Đánh giá kết quả sớm và mô tả kỹ thuật tái tạo van động mạch chủ bằng màng ngoài tim tự thân trong điều trị bệnh van động mạch chủ bất thường hai lá van. 21 bệnh nhân được phẫu thuật, trung bình 53 tuổi, nam/nữ là 2/1. 7 bệnh nhân van động mạch chủ hai lá van thực thụ (Type 0) được phẫu thuật tái tạo hai lá van, 14 bệnh nhân van động mạch chủ hai lá van với một đường đan ở giữa (Type I) được phẫu thuật tái tạo ba lá van. Không có bệnh nhân phải chuyển thay van động mạch chủ bằng van nhân tạo. Không bệnh nhân tử vong trong 30 ngày sau mổ. Thời gian theo dõi trung bình 18 tháng, không ghi nhận các biến chứng liên quan đến chảy máu hoặc huyết khối. Chênh áp tối đa thất trái- động mạch chủ 11.9 mmHg. Tái tạo van động mạch chủ bằng màng ngoài tim tự thân cho kết quả sớm tốt. Phương pháp tái tạo hai lá van hay ba lá van đều có kết quả khả quan tuỳ thuộc vào kiểu hình giải phẫu van động mạch chủ để lựa chọn.
Chi tiết bài viết
Từ khóa
Van ĐMC hai lá, Tái tạo van ĐMC, Màng ngoài tim tự thân, Phương pháp Ozaki.
Tài liệu tham khảo
1. De Mozzi P, Longo UG, Galanti G et al. Bicuspid aortic valve: A literature review and its impact on sport activity. British Medical Bulletin. 2008; 85(1): 63-85. doi:10.1093/bmb/ldn002
2. Roberts WC. The congenitally bicuspid aortic valve. A study of 85 autopsy cases. The American Journal of Cardiology. 1970; 26(1): 72-83. doi:10.1016/0002-9149(70)90761-7
3. Olson LJ, Subramanian R, Edwards WD. Surgical Pathology of Pure Aortic Insufficiency: A Study of 225 Gases. Mayo Clinic Proceedings. 1984; 59(11-12): 835-841. doi:10.1016/S0025- 6196(12)65618-3
4. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA / ACC Focused Update of the 2014 AHA / ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines; 2017. doi:10.1161/ CIR.0000000000000503
5. Bourguignon T, Bergöend É, Mirza A. Remplacement valvulaire par une prothèse mécanique: facteurs de risque des complications liées à la prothèse chez 505 patients suivis au long cours. 2011;15(1):23-30.
6. Jamieson WRE, Burr LH, Miyagishima RT, et al. Carpentier-Edwards supra- annular aortic porcine bioprosthesis: Clinical performance over 20 years. Journal of Thoracic and Cardiovascular Surgery. 2005;130(4):994- 1000. doi:10.1016/j.jtcvs.2005.03.040
7. Duran CMG, Gometza B, Kumar N, et al. Aortic valve replacement with freehand autologous pericardium. The Journal of Thoracic TẠP CHÍ NGHIÊN CỨU Y HỌC TCNCYH 137 (1) - 2021 133 and Cardiovascular Surgery. 1995; 110(2): 511- 516. doi:10.1016/S0022-5223(95)70248-2
8. Aicher D, Kunihara T, Abou Issa O, et al. Valve configuration determines long-term results after repair of the bicuspid aortic valve. Circulation. 2011; 123(2): 178-185. doi:10.1161/ CIRCULATIONAHA.109.934679
9. Meong GS, Hyun SY, Jong BC, et al. Aortic Valve Reconstruction with Use of Pericardial Leaflets. Texas Heart Institute journal. 2013; 41(6): 585-591. 10. Rankin JS, Nöbauer C, Crooke PS, et al. Techniques of autologous pericardial leaflet replacement for aortic valve reconstruction. Annals of Thoracic Surgery. 2014; 98(2): 743- 745. doi:10.1016/j.athoracsur.2013.11.086
11. Ozaki S, Kawase I, Yamashita H, et al. Reconstruction of bicuspid aortic valve with autologous pericardium - Usefulness of tricuspidization. Circulation Journal. 2014; 78(5): 1144-1151. doi:10.1253/circj.CJ-13-1335
12. Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. Journal of Thoracic and Cardiovascular Surgery. 2018; 155(6): 2379-2387. doi:10.1016/j.jtcvs.2018.01.087
13. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. Journal of Thoracic and Cardiovascular Surgery. 2007; 133(5): 1226- 1233. doi:10.1016/j.jtcvs.2007.01.039
14. Svensson LG, Adams DH, Bonow RO, et al. Aortic valve and ascending aorta guidelines for management and quality measures. Annals of Thoracic Surgery. 2013; 95(6 SUPPL.). doi:10.1016/j.athoracsur.2013.01.083
15. Minakata K, Schaff H V., Zehr KJ, et al. Is repair of aortic valve regurgitation a safe alternative to valve replacement? Journal of Thoracic and Cardiovascular Surgery. 2004; 127(3): 645-653. doi:10.1016/j.jtcvs.2003.09.018
16. Kawazoe K, Izumoto H, Tsuboi J, et al. Tricuspidization of incompetent bicuspid aortic valve. Journal of Thoracic and Cardiovascular Surgery. 2003; 126(3): 908-910. doi:10.1016/ S0022-5223(03)00391-X
17. Halees Z Al, Shahid M Al, Sanei A Al, Sallehuddin A, Duran C. Up to 16 years follow-up of aortic valve reconstruction with pericardium: A stentless readily available cheap valve? European Journal of Cardio-thoracic Surgery. 2005; 28(2): 200-205. doi:10.1016/j. ejcts.2005.04.041
18. Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self- developed aortic valve plasty system in aortic valve disease. Interactive Cardiovascular and Thoracic Surgery. 2011; 12(4): 550-553. doi:10.1510/icvts.2010.253682
19. Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. Journal of Thoracic and Cardiovascular Surgery. 2018; 155(6): 2379-2387. doi:10.1016/j.jtcvs.2018.01.087
20. Handa N, Miyata H, Motomura N, et al. Procedure-and age-specific risk stratification of single aortic valve replacement in elderly patients based on Japan adult cardiovascular surgery database. Circulation Journal. 2012; 76(2): 356-364. doi:10.1253/circj.CJ-11-0979
2. Roberts WC. The congenitally bicuspid aortic valve. A study of 85 autopsy cases. The American Journal of Cardiology. 1970; 26(1): 72-83. doi:10.1016/0002-9149(70)90761-7
3. Olson LJ, Subramanian R, Edwards WD. Surgical Pathology of Pure Aortic Insufficiency: A Study of 225 Gases. Mayo Clinic Proceedings. 1984; 59(11-12): 835-841. doi:10.1016/S0025- 6196(12)65618-3
4. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA / ACC Focused Update of the 2014 AHA / ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines; 2017. doi:10.1161/ CIR.0000000000000503
5. Bourguignon T, Bergöend É, Mirza A. Remplacement valvulaire par une prothèse mécanique: facteurs de risque des complications liées à la prothèse chez 505 patients suivis au long cours. 2011;15(1):23-30.
6. Jamieson WRE, Burr LH, Miyagishima RT, et al. Carpentier-Edwards supra- annular aortic porcine bioprosthesis: Clinical performance over 20 years. Journal of Thoracic and Cardiovascular Surgery. 2005;130(4):994- 1000. doi:10.1016/j.jtcvs.2005.03.040
7. Duran CMG, Gometza B, Kumar N, et al. Aortic valve replacement with freehand autologous pericardium. The Journal of Thoracic TẠP CHÍ NGHIÊN CỨU Y HỌC TCNCYH 137 (1) - 2021 133 and Cardiovascular Surgery. 1995; 110(2): 511- 516. doi:10.1016/S0022-5223(95)70248-2
8. Aicher D, Kunihara T, Abou Issa O, et al. Valve configuration determines long-term results after repair of the bicuspid aortic valve. Circulation. 2011; 123(2): 178-185. doi:10.1161/ CIRCULATIONAHA.109.934679
9. Meong GS, Hyun SY, Jong BC, et al. Aortic Valve Reconstruction with Use of Pericardial Leaflets. Texas Heart Institute journal. 2013; 41(6): 585-591. 10. Rankin JS, Nöbauer C, Crooke PS, et al. Techniques of autologous pericardial leaflet replacement for aortic valve reconstruction. Annals of Thoracic Surgery. 2014; 98(2): 743- 745. doi:10.1016/j.athoracsur.2013.11.086
11. Ozaki S, Kawase I, Yamashita H, et al. Reconstruction of bicuspid aortic valve with autologous pericardium - Usefulness of tricuspidization. Circulation Journal. 2014; 78(5): 1144-1151. doi:10.1253/circj.CJ-13-1335
12. Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. Journal of Thoracic and Cardiovascular Surgery. 2018; 155(6): 2379-2387. doi:10.1016/j.jtcvs.2018.01.087
13. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. Journal of Thoracic and Cardiovascular Surgery. 2007; 133(5): 1226- 1233. doi:10.1016/j.jtcvs.2007.01.039
14. Svensson LG, Adams DH, Bonow RO, et al. Aortic valve and ascending aorta guidelines for management and quality measures. Annals of Thoracic Surgery. 2013; 95(6 SUPPL.). doi:10.1016/j.athoracsur.2013.01.083
15. Minakata K, Schaff H V., Zehr KJ, et al. Is repair of aortic valve regurgitation a safe alternative to valve replacement? Journal of Thoracic and Cardiovascular Surgery. 2004; 127(3): 645-653. doi:10.1016/j.jtcvs.2003.09.018
16. Kawazoe K, Izumoto H, Tsuboi J, et al. Tricuspidization of incompetent bicuspid aortic valve. Journal of Thoracic and Cardiovascular Surgery. 2003; 126(3): 908-910. doi:10.1016/ S0022-5223(03)00391-X
17. Halees Z Al, Shahid M Al, Sanei A Al, Sallehuddin A, Duran C. Up to 16 years follow-up of aortic valve reconstruction with pericardium: A stentless readily available cheap valve? European Journal of Cardio-thoracic Surgery. 2005; 28(2): 200-205. doi:10.1016/j. ejcts.2005.04.041
18. Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self- developed aortic valve plasty system in aortic valve disease. Interactive Cardiovascular and Thoracic Surgery. 2011; 12(4): 550-553. doi:10.1510/icvts.2010.253682
19. Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. Journal of Thoracic and Cardiovascular Surgery. 2018; 155(6): 2379-2387. doi:10.1016/j.jtcvs.2018.01.087
20. Handa N, Miyata H, Motomura N, et al. Procedure-and age-specific risk stratification of single aortic valve replacement in elderly patients based on Japan adult cardiovascular surgery database. Circulation Journal. 2012; 76(2): 356-364. doi:10.1253/circj.CJ-11-0979