Individualized Treatment Of Severe Aortic Stenosis

Objective:Summary of individual surgical procedure for the treatment of patients with severe aortic stenosis with different types of lesions. Methods:Retrospective collection of 335 patients with severe aortic valve stenosis undergoing aortic valve replacement(AVR) from 2001 to 2015.Patients were divided into two groups according to the size of the aortic annulus and whether the patient was matched with the criteria.Patients in gpoup A were normal or enlarged aortic rings. Aortic valve replacement without aortic annulus enlargement. A group of 292 patients, including 223 cases received simple aortic valve replacement, 21 cases received Bental procedure,33 cases received aortic valve replacement and ascending aorta prosthetic vessel replacement,15 cases received aortic valve replacement and ascending aortic angioplasty.Group B patients with small aortic annulus,43 cases received aortic valve replacement combined with aortic root enlargement. Aortic root enlargement techniques included Konno in 7 cases,Manouguian in 25 cases,Nicks in 11 cases.Patients were followed up and received ultrasonic cardiogram(UCG)1 week and 12 months postoperatively and t-test was used for statistical comparison. Result:There was no operative mortality.Operation time of Two groups 3.3 ~7.9h,mean(4.8±1.2)h.CPB time 80 ~ 260 min,mean( 160±33.7) min,bleed 200 ~1400ml,mean( 698±260) ml.20 cases( 5.98%) frequent premature ventricular contractions occurred,36 cases(10.75%)supraventricular tachycardia occurred, 11?(3.28%)low cardiac output syndrome occurred, 4?(1.19%) ?°AVB occurred. Patients were followed up and received ultrasonic cardiogram(UCG) 12 months postoperatively. The left ventricle was reduced, and the cardiac function was obviously improved. Conclusion:Once the patients with severe aortic stenosis is diagnosed,without surgical contraindications, should be operated as soon as possible.According to the specific circumstances, different aortic valve diseases can be taken individual procedure to achieve good results.