遠隔成績からみた大動脈弁形成術の有用性

Long-term Benefit of Aortic Valve Repair

僧帽弁閉鎖不全症（MR）に対しては形成術の有用性が確立され，早期手術が推奨されている．大動脈弁閉鎖不全症（AR）に対しては人工弁置換術を行う施設が多く，弁形成を行っている施設は少ないが，以前より積極的に行っている施設からの遠隔成績も発表されるようになり，新たに取り組んでいる施設も少なくない1，2）．当院では以前より大動脈弁形成術に積極的に取り組んできた．当院における大動脈弁形成術の長期・遠隔成績を検討し，今後の方向性を考えたい．

Long-term results of valve repair for aortic regurgitation is not still clear. We investigated retrospectively our results of aortic valve repair for 244 patients. There were 2 operative death and 7 late cardiac death. Ten-year late survival rate was 84％ and 10-year reoperation free rate was 74％．That of congenital group was 57％．However, 10-year reoperation rate was 87％ for Type 1 group and 79％ for Type 2 group. Recent technical evolution such as introduction of 4-dimensional computed tomography （CT） and intraoperative measurement of effective height may contribute improvement of repair technique. Further accumulation of evidence will promote earlier surgery for patients with aortic regurgitation.