قصور الأبهر مع توسع جذر الأبهر: الإدارة الجراحية في المرضى الصغار

References

• The presence of associated aortic dilatation dictates surgery, irrespective of AR severity.
• Valve-sparing aortic root replacement is recommended in young patients with aortic root dilatation at experienced centres, when durable results are expected.
• When AV surgery is indicated and the predicted surgical risk is low, replacement of the aortic root or ascending aorta should be considered if the maximal diameter is ≥45 mm.
• In patients with root enlargement and good tissue quality (i.e. pliable AV cusps with normal motion), a valve-sparing procedure has been demonstrated to be superior to the use of a composite valve graft (Bentall procedure) in terms of long-term mortality and overall morbidity (thromboembolism and endocarditis, with similar need for reoperation), and should be therefore favoured by experienced centres, in particular in patients with an estimated long life expectancy.

DOI: 10.1093/eurheartj/ehaf194