Клапаносохраняющие операции в реконструктивной хирургии корня аорты у больных синдромом Марфана: систематический обзор

Автор: Комаров Р.Н., Нормурадов Акмаль Улугбекович, Исаев Р.М., Соборов М.А., Ропова А.И., Рейтер В.Д.

Журнал: Патология кровообращения и кардиохирургия @journal-meshalkin

Статья в выпуске: 3 т.26, 2022 года.

Бесплатный доступ

Цель. Проанализировать результаты клапаносохраняющих операций в хирургии корня аорты у больных синдромом Марфана в литературе. Методы. Проведен обширный поиск с использованием баз данных Pubmed, Embase, Cochrane Library и Web of Science. Статьи для анализа выбраны согласно методологии клинической эпидемиологии PRISMA 2020. Результаты. В 19 исследованиях и 4 метаанализах 30-дневная и госпитальная летальность не превышала 2,08 %. Частота тромбоэмболии за 15-летний период - 4,1 ± 2,0 %. Средний показатель инфекционного эндокардита - 0,25 %. Свобода от тяжелой аортальной недостаточности через 8 лет после операции - 95,2 ± 3,3 %. Свобода от повторных вмешательств за 8 и 10 лет - 97 %. Отдаленная летальность - не более 10,57 %. Выживаемость за 5 и 10 лет - 95,4 и 84,2 % соответственно. Заключение. В ближайшем и отдаленном периодах клапаносохраняющие операции показывают преимущество по сравнению с имплантацией клапаносодержащего кондуита у больных синдромом Марфана. В отдаленном периоде тромбоэмболия, эндокардит, кровотечение достоверно чаще наблюдались у больных с клапаносодержащим кондуитом.

Еще

Аневризма корня аорты, клапаносохраняющая операция, операция дэвида, реимплантация, синдром марфана

Короткий адрес: https://sciup.org/142235607

IDR: 142235607 | DOI: 10.21688/1681-3472-2022-3-21-30

Список литературы Клапаносохраняющие операции в реконструктивной хирургии корня аорты у больных синдромом Марфана: систематический обзор

David T.E., Maganti M., Armstrong S. Aortic root aneurysm: principles of repair and long-term follow-up. J Thorac Cardiovasc Surg. 2010;140(6 Suppl):S14-S19; discussion S45-S51. PMID: 21092781. https://dx.doi.org/10.1016/i. jtcvs.2010.07.041
Pacini D., Petridis F.D., Rasovic O., Di Bartolomeo R. Aortic valve-sparing operations. Expert Rev Cardiovasc Ther. 2010;8(7):933-940. PMID: 20602554. https://dx.doi.org/10.1586/erc.10.70
David T.E. Aortic valve sparing in different aortic valve and aortic root conditions. J Am Coll Cardiol. 2016;68(6):654-664. PMID: 27491910. https://dx.doi.org/10.1016/i. jacc.2016.04.062
David T.E., Feindel C.M. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1992;103(4):617-621; discussion 622. PMID: 1532219. https://dx.doi. org/10.1016/S0022-5223(19)34942-6
Kirklin J.W., Barratt-Boyes B.G., editors. Cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications. Vol. 1. New York: Churchill Livingstone; 1993. pp. 520-523.
David T.E., David C.M., Manlhiot C., Colman J., Crean A.M., Bradley T. Outcomes of aortic valve-sparing operations in Marfan syndrome. J Am Coll Cardiol. 2015;66:1445-1453. PMID: 26403341. https://dx.doi.Org/10.1016/i.iacc.2015.07.041
David T.E., Feindel C.M., David C.M., Manlhiot C. A quarter of a century of experience with aortic valve-sparing operations. J Thorac Cardiovasc Surg. 2014;148(3):872-879; discussion 879-880. PMID: 24930611. https://dx.doi.org/10.1016/i. itcvs.2014.04.048
Erasmi A.W., Sievers H.-H., Bechtel J.F.M., Hanke T., Stierle U., Misfeld M. Remodeling or reimplantation for valve-sparing aortic root surgery? Ann Thorac Surg. 2007;83(2):S752-S756; discussion S785-S790. PMID: 17257921. https://dx.doi. org/10.1016/i.athoracsur.2006.10.093
Bethea B.T., Fitton T.P., Aleio D.E., Barreiro C.J., Cattaneo S.M., Dietz H.C., Spevak P.J., Lima J.A., Gott V.L., Cameron D.E. Results of aortic valve-sparing operations: experience with remodeling and reimplantation procedures in 65 patients. Ann Thorac Surg. 2004;78(3):767-772. PMID: 15336989. https:// dx.doi.org/10.1016/i.athoracsur.2004.03.040
Salvi P., Grillo A., Marelli S., Gao L., Salvi L., Viecca M., Di Blasio A.M., Carretta R., Pini A., Parati G. Aortic dilatation in Marfan syndrome: role ofarterial stiffness and fibrillin-1 variants. JHypertens. 2018;36(1):77-84. PMID: 29210860. https://dx.doi. org/10.1097/HJH.0000000000001512
Ho N.C.Y., Tran J.R., Bektas A. Marfan's syndrome. Lancet. 2005;366(9501 ):1978-1981. PMID: 16325702. https://dx.doi. org/10.1016/S0140-6736(05)66995-4
Keane M.G., Pyeritz R.E. Medical management of Marfan syndrome. Circulation. 2008;117(21):2802-2813. PMID: 18506019. https://dx.doi.org/10.1161/ CIRCULATI0NAHA.107.693523
Martens A., Beckmann E., Kaufeld T., Fleissner F., Neuser J., Korte W., Merz C., Krueger H., Haverich A., Shrestha M. Valve-sparing aortic root replacement (David I procedure) in Marfan disease: single-centre 20-year experience in more than 100 patients. Eur J Cardiothorac Surg. 2019;55(3):476-483. PMID: 30169770. https://dx.doi.org/10.1093/eicts/ezy300
Svensson L.G., Blackstone E.H., Alsalihi M., Batizy L.H., Roselli E.E., McCullough R., Vivacqua A., Moran R.T., Gillinov A.M., Thamilarasan M., Griffin B., Hammer D.F., Stewart W.J., Sabik J.F. 3rd, Lytle B.W. Midterm results of David reimplantation in patients with connective tissue disorder. Ann Thorac Surg. 2013;95(2):555-562. PMID: 23286971. https:// dx.doi.org/10.1016/i.athoracsur.2012.08.043
Kallenbach K., Baraki H., Khaladi N., Kamiya H., Hagl C., Haverich A., Karck M. Aortic valve-sparing operation in Marfan syndrome: what do we know after a decade? Ann Thorac Surg. 2007;83(2):S764-S768; discussion S785-S790. PMID: 17257923. https://dx.doi.org/10.1016/i.athoracsur.2006.10.097
Kari F.A., Beyersdorf F., Rylski B., Stephens E.H., Russe M., Siepe M. David I reimplantation procedure for aortic root replacement in Marfan patients: medium-term outcome. Interact Cardiovasc Thorac Surg. 2014;19(5):743-748. PMID: 25047948. https://dx.doi.org/10.1093/icvts/ivu244
Kremer J., Farag M., Zaradzki M., Szabö G., Ruhparwar A., Kallenbach K., Karck M., Arif R. The reimplantation valve-sparing aortic root replacement technique for patients with Marfan syndrome: A single-center experience. Sci Rep. 2019;9( 1 ):12021. PMID: 31427685; PMCID: PMC6700152. https://dx.doi.org/10.1038/s41598-019-48572-9
Coselli J.S., Volguina I.V., LeMaire S.A., Sundt T.M., Connolly H.M., Stephens E.H., Schaff H.V., Milewicz D.M., Vricella L.A., Dietz H.C., Minard C.G., Miller D.C., Aortic Valve Operative Outcomes in Marfan Patients study group. Early and 1-year outcomes of aortic root surgery in patients with Marfan syndrome: a prospective, multicenter, comparative study. J Thorac Cardiovasc Surg. 2014;147(6):1758-1766,1767. e1-4. PMID: 24655904. https://dx.doi.org/10.1016/i. jtcvs.2014.02.021
Song H.K., Preiss L.R., Maslen C.L., Kroner B., Devereux R.B., Roman M.J., Holmes K.W., Tolunay H.E., Desvigne-Nickens P., Asch F.M., Milewski R.K., Bavaria J., LeMaire S.A., GenTAC Consortium. Valve-sparing aortic root replacement in patients with Marfan syndrome enrolled in the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions. J Heart Valve Dis. 2014;23(3):292-298. PMID: 25296451; PMCID: PMC4995179.
Ouzounian M., Rao V., Manlhiot C., Abraham N., David C., Feindel C.M., David T.E. Valve-sparing root replacement compared with composite valve graft procedures in patients with aortic root dilation. J Am Coll Cardiol. 2016;68(17):1838-1847. PMID: 27765186. https://dx.doi.org/10.1016/i. jacc.2016.07.767
Settepani F., Szeto W.Y., Pacini D., De Paulis R., Chiariello L., Di Bartolomeo R., Gallotti R., Bavaria J.E. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study. Ann Thorac Surg. 2007;83(2):S769-S773; discussion S785-S790. PMID: 17257924. https://dx.doi.org/10.1016/i. athoracsur.2006.10.084
Price J., Magruder J.T., Young A., Grimm J.C., Patel N.D., Alejo D., Dietz H.C., Vricella L.A., Cameron D.E. Long-term outcomes of aortic root operations for Marfan syndrome: A comparison of Bentall versus aortic valve-sparing procedures. J Thorac Cardiovasc Surg. 2016;151(2):330-336. PMID: 26704057. https://dx.doi.org/10.1016/Utcvs.2015.10.068
Martín C.E., Villar S., Serrano-Fiz S., Moñivas V., González A., Forteza A. Long-term outcomes of aortic valve reimplantation in Marfan syndrome. Rev Esp Cardiol (Engl Ed). 2020;73(1):96-97. PMID: 31561983. https://dx.doi.org/10.1016/j.rec.2019.06.011
Schoenhoff F.S., Langhammer B., Wustmann K., Reineke D., Kadner A., Carrel T. Decision-making in aortic root surgery in Marfan syndrome: bleeding, thromboembolism and risk of reintervention after valve-sparing or mechanical aortic root replacement. Eur J Cardiothorac Surg. 2015;48(6):931-935; discussion 935-936. PMID: 25666470. https://dx.doi. org/10.1093/ejcts/ezu553
Urbanski P.P., Jankulowski A., Morka A., Irimie V., Zhan X., Zacher M., Diegeler A. Patient-tailored aortic root repair in adult marfanoid patients: Surgical considerations and outcomes. J Thorac Cardiovasc Surg. 2018;155(1 ):43-51 .e1. PMID: 28673709. https://dx.doi.org/10.1016/_i.jtcvs.2017.05.108
Kunihara T., Aicher D., Rodionycheva S., Asano M., Tochii M., Sata F., Schäfers H.-J. Outcomes after valve-preserving root surgery for patients with Marfan syndrome. J Heart Valve Dis. 2012;21(5):615-622. PMID: 23167226.
Volguina I.V., Miller D.C., LeMaire S.A., Palmero L.C., Wang X.L., Connolly H.M., Sundt T.M. 3rd, Bavaria J.E., Dietz H.C., Milewicz D.M., Coselli J.S., Aortic Valve Operative Outcomes in Marfan Patients study group. Valve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: Analysis of early outcome. J Thorac Cardiovasc Surg. 2009;137(5):1124-1132. PMID: 19379977. https://dx.doi.org/10.1016/Kitcvs.2009.03.023
Schmidtke C., Karluss A., Sier H., Huppe M., Brauer K., Sievers H.-H. Mid-term results of different aortic valve-sparing procedures in Marfan syndrome. J Heart Valve Dis. 2012;21(2):195-201, discussion 202. PMID: 22645855.
Forteza A., De Diego J., Centeno J., López M.J., Pérez E., Martín C., Sánchez V., Rufilanchas J.J., Cortina J. Aortic valve-sparing in 37 patients with Marfan syndrome: midterm results with David operation. Ann ThoracSurg. 2010;89(1):93-96. PMID: 20103213. https://dx.doi.org/10.1016Xi. athoracsur.2009.09.015
Cameron D.E., Alejo D.E., Patel N.D., Nwakanma L.U., Weiss E.S., Vricella L.A., Dietz H.C., Spevak P.J., Williams J.A., Bethea B.T., Fitton T.P., Gott V.L. Aortic root replacement in 372 Marfan patients: evolution of operative repair over 30 years. Ann Thorac Surg. 2009;87(5):1344-1349; discussion 1349-1350. PMID: 19379862. https://dx.doi.org/10.1016/_i.athoracsur.2009.01.073
Hu R., Wang Z., Hu X., Wu H., Wu Z., Zhou Z. Surgical reconstruction of aortic root in Marfan syndrome patients: a systematic review. J Heart Valve Dis. 2014;23(4):473-483. PMID: 25803974.
David T.E. The aortic valve-sparing operation. J Thorac Cardiovasc Surg. 2011;141(3):613-615. PMID: 21335120. https://dx.doi.Org/10.1016/i.itcvs.2010.11.039
Flynn C.D., Tian D.H., Wilson-Smith A., David T., Matalanis G., Misfeld M., Mastrobuoni S., El Khoury G., Yan T.D. Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement. Ann Cardiothorac Surg. 2017;6(6):570-581. PMID: 29270369; PMCID: PMC5721109. https://dx.doi.org/10.21037/acs.2017.11.06
Burgstaller J.M., Held U., Mosbahi S., Stak D., Steurer J., Eckstein F., Berdajs D.A. A systemic review and meta-analysis: long-term results of the Bentall versus the David procedure in patients with Marfan syndrome. Eur J Cardiothorac Surg. 2018;54(3):411-419. PMID: 29893811. https://dx.doi. org/10.1093/ejcts/ezy158
Benedetto U., Melina G., Takkenberg J.J.M., Roscitano A., Angeloni E., Sinatra R. Surgical management of aortic root disease in Marfan syndrome: a systematic review and metaanalysis. Heart. 2011;97(12):955-958. PMID: 21228428. http:// dx.doi.org/10.1136/hrt.2010.210286
Soto M.E., Ochoa-Hein E., Anaya-Ayala J.E., Ayala-Picazo M., Koretzky S.G. Systematic review and meta-analysis of aortic valve-sparing surgery versus replacement surgery in ascending aortic aneurysms and dissection in patients with Marfan syndrome and other genetic connective tissue disorders. J Thorac Dis. 2021;13(8):4830-4844. PMID: 34527322; PMCID: PMC8411183. https://dx.doi.org/10.21037/jtd-21-789
DavidT.E., David C.M., Feindel C.M., Manlhiot C. Reimplantation of the aortic valve at 20 years. J Thorac Cardiovasc Surg. 2017;153(2):232-238. PMID: 27923487. https://dx.doi. org/10.1016/j.jtcvs.2016.10.081

Еще

Статья обзорная