Analysis Of Surgical Treatment Of Bicuspid Aortic Valve

Objective:To analyze and evaluate the effect of surgical treatment of bicuspid aortic valve malformation.Methods:A retrospective analysis of 61 patients with bicuspid aortic valve malformation in the First Affiliated Hospital of Guangxi Medical University from January 2016 to December 2019 was analyzed.This study was divided into single aortic valve based on different surgical methods.Replacement surgery(AVR)group,aortic valve replacement + ascending aortaplasty or aortic replacement(AVR-AR)group.The left ventricular ejection fraction,left ventricular end diastolic diameter,left ventricular end contraction diameter,and maximum blood flow velocity of the aortic valve were compared and observed before operation,1 week after operation,3 months after operation,and 1 year after operation.The postoperative complications and mortality of the patients were evaluated for the curative effect of the operation,and the ascending was evaluated by comparing the two surgical methods of combined ascending aorta dilatation and inner diameter ≥40mm,simple aortic replacement and aortic valve replacement+ascending aortic angioplasty.The influence of the aorta.Measurement data are expressed as mean±standard deviation,using t test;counting data are expressed as percentage(rate),using chi-square test;when P<0.05,the difference is considered to be statistically significant.Results:In the AVR group,8 cases underwent mitral valve replacement or mitral valvuloplasty at the same time.In the AVR-AR group,3 cases underwent mitral valve replacement or mitral valvuloplasty at the same time.The P values of extracorporeal circulation time,ventilator use time,and intensive care time were all less than 0.05.1 case died in the AVR group during the perioperative period,8 cases(19.0%)in the AVR group with postoperative pneumonia,6 cases(31.5)in the AVR-AR group,11 cases(26.2%)in the AVR group with renal insufficiency,and 8 cases in the AVR-AR group(42.1%).There was no malignant ventricular rate during the perioperative period in the two groups.The comparison of echocardiographic results is as follows: AVR group: P=0.93>0.05 before LVEF compared with 1 week after operation,P values are all compared with 3 months after operation and 1 week after operation,and 1 year after operation and 3 months after operation.Less than 0.05;LVEDD and LVESD 1week after operation and before operation,3 months after operation and 1 week after operation,1 year after operation and 3 months after operation,the P value is less than 0.05;the maximum blood flow velocity of aortic valve is 1P=0<0.05 compared with preoperative week,P>0.05 compared with 3 months after operation,1 year after operation and 3 months after operation,P>0.05;AVR-AR group: 1 week after LVEF and before operation Compared with P=0.21>0.05,the P values were less than 0.05 compared with 3 months after operation and 1 week after operation,1 year after operation and 3 months after operation;LVEDD and LVESD 1 week after operation and before operation and3 months after operation Compared with 1 week after operation,1 year after operation,and 3 months after operation,the P value was less than 0.05;the maximum blood flow velocity of the aortic valve was compared before operation and 1 week after operation,P=0<0.05,3 months after operation and after operation P values were greater than 0.05 at 1 week,1 year after surgery,and 3 months after surgery;LVEF,LVEDD,LVESD,maximum aortic valve blood before surgery,1 week after surgery,3 months after surgery,and 1 year after surgery between the two groups The relative P values between the flow velocities are all greater than 0.05.Patients with dilated ascending aorta and inner diameter ≥40mm underwent aortic valve replacement and aortic valve replacement+ascending aortic angioplasty.The P values were less than 0.05 at 1year after surgery and at 1 week after surgery,but between the two groups Compared with the difference between 1 year after operation and 1 week after operation,P was greater than 0.05.Postoperative follow-up showed that 2patients in the AVR group had occasional chest tightness,no dizziness,fainting,etc.There were no deaths and aortic dissections in the two groups,1 patient in the AVR group had cerebral hemorrhage six months after the operation,and 1patient in the AVR group 2 Mechanical valve thrombosis occurred in 2016 and requires a second operation to replace the valve again.Conclusions:1.Aortic valve replacement can treat the clinical symptoms of BAV patients.The incidence of serious complications and mortality after simple aortic valve replacement and aortic valve replacement + ascending aortic angioplasty or aortic replacement are both Lower,it is a safe and effective means to treat BAV.2.For BAV patients with ascending aorta dilation,whether aortic valve replacement alone or aortic valve replacement + ascending aortaplasty is performed,the ascending aorta may continue to expand after surgery.