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大動脈基部拡大に対する自己弁温存基部置換術は,良好な長期成績が報告されており,有効な治療法として適応拡大がなされている1).大動脈弁に内在する問題があり,手術適応となる大動脈弁逆流(AR)がある場合に,併存する軽度~中等度のValsalva洞拡大に対して,弁形成に加えて大動脈基部を置換することは有用と思われる.僧帽弁形成術と同様の,弁輪縫縮による接合面積の増加が期待できるからである.しかし,僧帽弁
Ninety-nine patients underwent valve sparing aortic root replacement, mostly using reimplantation technique. Mean age was 56.1±13.4 years. Indication of this type of operation was extended to patients with significant aortic regurgitation (AR) accompanied by sinus Valsalva diameter more than 40 mm. Bicuspid valve presented in 17 patients. The proportion of severe AR was 55%. Valve plasty technique included central plication (n=61) and pericardial patch (n=7). Operative mortality was 1%. AR grade at discharge was none or trivial in 87 patients (88%). Five-year survival rate was 96%. There were 5 reoperation and 2 patients underwent re-repair. Five-year reoperation free rate was 96%.
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