ZHANGLiang , CHANGQian , YUCun-tao , SUNXiao-gang , QIANXiang-yang
  • State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, P. R. China;
CHANGQian, Email: docchangqian@163.com
Rheumatic aortic valve disease; Aortic disease; Reoperation
10.7507/1007-4848.20150028
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Objective To explore the reoperation on aortic diseases in patients with previous aortic valve surgery due to rheumatic aortic valve disease, improve the understanding of aortic valve disease secondary to surgery of aortic valve. Methods We retrospectively analyzed the data of twenty-seven patients with previous aortic valve replacement due to rheumatic aortic valve disease underwent aortic root or other aortic operation in Fu Wai Cardiovascular Hospital because of new aortic root or aortic diseases between August 2003 and May 2012. All the patients with new aortic diseases were diagnosed by cardiac ultrasound and aortic computed tomography. The new diseases included type A aortic dissection in 13 patients, ascending aortic aneurysm in 6 patients, and aortic root aneurysm in 8 patients. There were 20 males and 7 females with mean age of 50±10 years (ranged 28-69 years). Seven patients underwent aortic root replacement, 6 patients received ascending aorta and total aortic arch replacement combined with stented graft implantation into the descending aorta, 6 patients received aortic root and total aortic arch replacement combined with stented graft, and 8 patients received the ascending aorta replacement. All patients were followed by clinic interview or telephone. Results The interval time for reoperation was 6-110 (57±32) months. No patient died within 30 days after operation. Cardiopulmonary bypass time was 50-274 (143±65) minutes; hospital stay was 13-27 (19±11) days. Four patients had renal insufficiency after operation and all were cured by hemofiltration before departure. Three patients had neurological complications of transient brain dysfunction, and there was no postoperative spinal cord deficits occurred. Four patients had pulmonary complication. The mean follow up time were 4-118 (43.5±32.2) months. Five patients were missed and 4 cases died during the follow-up. The follow-up rate was 81.5%. Three-year survival rate was 85.1%. There was no case received third operation due to aortic disease during the follow-up. Conclusion We should pay more attention to patients with previous surgery due to rheumatic aortic valve disease, especially to patients combined with enlarged ascending aorta, so that aortic adverse events following to aortic valve operation can be reduced or be avoided in long term.

Citation： ZHANGLiang, CHANGQian, YUCun-tao, SUNXiao-gang, QIANXiang-yang. Reoperation for Secondary Aortic Diseases of Patients with Previous History of Aortic Valve Surgery for Rheumatic Aortic Valve Disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(2): 100-103. doi: 10.7507/1007-4848.20150028 Copy