基部拡大を伴わない大動脈弁逆流に対する大動脈弁形成としてのreimplantation法

Aortic Valve Repair with Reimplantation in Small Aortic Root

大動脈弁形成術はこの20年間で発展を遂げてきた．その中心となるテクニックは自己弁温存基部置換術であり，一つがremodeling法1），もう一つがreimplantation法2）である．基部拡大とそれに伴う大動脈弁逆流（AR）に対して，reimplantation法と弁尖の形成術，あるいはremodeling法とsutureまたはbandによるannuloplastyが報告されている3～5）．し

Annular fixation has an important role aortic valve repair for aortic regurgitation. We have used the reimplantation procedure as annular fixation combined with cusp repair rechniques for aortic valve repair even in small aortic root （＜50 mm） since 2010. Freedom from aortic valve reoperation was 93％ at 5 years and 79％ at 8 years. Freedom from greater than moderate aortic regurgitation was 80％ at 5 years and 71％ at 8 years. Although the outcomes were not satisfactory and should be improved, this technique would be one of choices in selected patients, considering durability of bioprostheses and anticoagulation-related events in mechanical valves.