Analysis Of The Efficacy Of Aortic Valve Replacement Combined With Ascending Aortoplasty In The Treatment Of Aortic Valve Disease With Ascending Aortic Dilatation

Objective To investigate the effect of aortic valve replacement and ascending aortic folding in patients with aortic valve disease complicated with ascending aortic dilatation.Methods From January 2016 to January 2019,53 patients with aortic valve disease complicated with ascending aorta dilatation underwent cardiac and macrovascular surgery in the General Hospital of Ningxia Medical University were retrospectively analyzed.They were divided into two groups according to the different operation:Ascending aortic angioplasty group(group I),all patients underwent aortic valve replacement combined with ascending aortic angioplasty;Aortic valve replacement group(group II),all patients underwent aortic valve replacement without ascending aortoplasty.Comparing the data of two groups of nodes at the same time and the data of different time points in the same group,we can draw a conclusion.Two groups of patients were divided into two subgroups according to whether or not aortic valvular bicuspid deformity was combined(Ia、Ib、IIa、IIb).By comparing the changes of ascending aorta in one week and six months after operation in the same group,the effect of aortic valve bicuspid deformity on the efficacy of two different operations for ascending aortic dilatation was evaluated.Results A total of 53 patients were enrolled in this study.All patients were followed up for 6-35 months,with an average follow-up of(17.64 +7.14)months.There were 27 cases in group I,20 males and 7 females;26 cases in group II,19 males and 7 females.There were no significant differences in height,weight,age,preoperative left ventricular end-diastolicdiameter,left ventricular end-diastolic volume and ejection fraction between the two groups.1、According to different surgical groups,the diameter of ascending aorta in group I was larger than that in group II(48.41±3.92 mm vs 45.35±3.62 mm,P =0.005).After operation the diameter of ascending aorta in group I was significantly smaller than that in group II(39.33±2.70 mm vs 44.54±3.82 mm,P <0.05).In group I,the diameter of ascending aorta was significantly reduced at 1 week after operation(39.33 ± 2.70 mm vs48.41±3.92 mm,P <0.05),and no significant dilation was observed at follow-up period(39.52±3.09 mm vs 39.52±2.91 mm,P =1)compared with that at 1 week after operation;in group II,the diameter of ascending aorta at 1 week after operation was not significantly different from that at follow-up period(p=1).There were no deaths or adverse events of aorta between the two groups.There were no significant differences in the time of cardiopulmonary bypass,the time of occlusion of ascending aorta,the time of ICU stay and the days of hospitalization between the two groups.The diameter of ascending aorta in Ia and Ib groups decreased significantly at 1 week after operation,and no significant dilation was observed at follow-up period compared with 1 week after operation.There was no significant difference in the diameter of ascending aorta between IIa and IIb groups at 1 week after operation compared with that before operation and follow-up period compared with that at 1 week after operation.Conclusion Aortic valve replacement combined with ascending aortoplasty in the treatment of aortic valve disease with ascending aortic dilatation is safe and reliable;Bilobular aortic valve deformity does not affect the outcome of ascending aortoplasty;Long-term outcomes of ascending aortoplasty still need to be followed up.