摘要
Abstract
Objective Comparison of propensity score matching method is balanced reserves the aortic root replace-ment valve leaflets ( VSRR procedure) and artificial vascular ascending aorta with aortic valve replacement surgery ( Bentall procedure), surgical treatment of confounding factors, evaluation of the perioperative security of the two groups of patients with surgery.Methods From September 2005 to September 2015, in our hospital, 186 cases of the aortic root disease patients were enrolled, 48 cases including VSRR surgery, Bentall surgery in 138 cases, logistic regression estimation method was used to calculate the propensity score matching score, comparison of propensity score matching research method, find out the best matching of 48 cases with VSRR surgery.By comparing two groups of surgery intra-operative, postoperative results evaluation VSRR surgery compared with Bentall's safety and applicability.Results Valve Sparing Aortic Root Replacement ( VSRR) surgery and artificial vascular ascending aorta with aortic valve replacement surgery ( Bentall procedure) in surgical operation time VSRR group (6.8 ±1.9) h and Bentall group (5.7 ±2.1) h ( t =242.36, P =242.36).Extracorporeal circulation time VSRR group (203.1 ±60.1) min and Bentall group (194.3 ±71.2) min ( t =33.771, P =33.771), the aorta bloc-king time, VSRR group (154.4 ±42.0) min and Bentall group (131.6 ±46.1) min and ( t =187.76, P =187.76), in the intensive care unit (ICU) time VSRR group (34.5 ±38.6) and Bentall group (37.5 ±21.1) h, ( t =0.41, P =0.41).There was no significant difference in such aspects.In the two groups in the aortic valve average pressure differential across the valve VSRR group (9.56 ±6.51) mmHg and Bentall mmHg (13.07 ±7.53), ( t =67.23, P =67.23).Aortic average pressure differential across the valve VSRR group (18.0 ±2.11) mmHg and Bentall group (23.37 ±11.8) mmHg, there was statistically difference( t =124.72, P =124.72).Postoperative echocardiography in patients with aortic valve a-bove moderate regurgitation VSRR group (2.1%) and Bentall group (0%).The rest in mortality VSRR group (4.2%) and Bentall (2.1%), ( t =277.642, P =277.642), postoperative complications (arrhythmia, secondary bleeding, chest sur-gery mental symptoms of infection, acute renal failure) there was no statistically significant difference in incidence, ( P =0.61), VSRR and Bentall group in perioperative survival and there was no statistically significant difference between the rate of adverse events.Conclusion After contrast propensity score matching method is balanced, reserve the aortic root replace-ment valve leaflets ( VSRR surgery) and artificial vascular ascending aorta with aortic valve replacement surgery ( Bentall sur-gery) in peri-operative survival and adverse events showed no significant statistical differences in echocardiography.关键词
保留瓣叶的主动脉根部置换术/带主动脉瓣人工血管升主动脉替换术/倾向性评分匹配对比研究/围手术期/安全性Key words
VSRR procedure/Bentall procedure/Propensity score matching study/Perioperative/Safety
