EurJCardiothoracSurgJun1;51(6):-PMID:
Tom?icA,SchneiderAW,PalmenM,vanBrakelTJ,VersteeghMIM,KlautzRJM
DepartmentofCardiothoracicSurgery,LeidenUniversityMedicalCenter,Leiden,Netherlands.
OBJECTIVES:Severecasesofinfectiveendocarditis(IE)oftheaorticvalvecancauseaorticrootdestructionandaffectthesurroundingstructures,includingtheaortic-mitralcontinuity,theanteriormitralvalveleafletandtheroofoftheleftatrium.Reconstructionafterresectionofallinfectedtissueremainschallenging.Wedescribeoursurgicalapproachandthemid-termresults.
METHODS:BetweenJanuaryandDecember,35patientsunderwentsurgeryforextensiveIEoftheaorticvalvewithdestructionoftheaorticroot,theaortic-mitralcontinuityandthemitralvalve.Meanagewas60.4?±?13.7;26/35(74%)patientshadprostheticvalveendocarditis.Fourpatientswereincriticalpreoperativestate.MedianEuroSCOREIIwas18.0%[interquartilerange(IQR)11.0-26.7].
RESULTS:Aorticrootreplacementwasperformedin32(91%)patients.Theremainingpatientsunderwentaorticvalvereplacement.Reconstructionoftheaortic-mitralcontinuityandtheroofoftheleftatriumwereperformedusingafoldedpericardialpatch.In28patients(80%),mitralvalverepairwasperformed.Postoperativemechanicalcirculatorysupport,acutekidneyfailureandsurgicalre-explorationwereseenin5(16%),10(31%)and4(13%)patients,respectively.Earlysurvivalratewas77%(27patients).Duringamedianfollow-upof29.8months(IQR6.4-62.9),7(26%)patientsrequiredreintervention(3-42monthsaftersurgery);4wereduetomitralin北京哪里治疗白癜风效果好北京白癜风是怎样引起的
