Senior Patients With Ascending Aortic Dilation Caused By Aortic Valve Disease

Objective: To compare and analyze the surgical data of senior patients(65 years and older)with ascending aortic dilation caused by aortic valve disease under the treatment of aortic angioplasty or ascending aortic replacement(Wheat)while performing aortic valve replacement(AVR).The post-surgical effects and differences in the near and medium term will be investigated.Methods: We conducted a retrospective analysis of ascending aortic dilatation caused by aortic valve disease diagnosed in Anhui Provincial Hospital from November 2013 to February 2018.A total of 67 senior patients with an upper aortic dilatation between 40-55 mm,aortic sinus with a normal size or slight enlargement but no significant displacement of the left and right coronary artery openings were included in our database.These patients were divided into two groups according to different surgical procedures: 44 patients with AVR combined with ascending aortic angioplasty and 23 patients with AVR combined with ascending aortic replacement(Wheat).We compared the differences between biomedical indicators,quality of life indicators,hospitalization cost indicators and other indicators between the two groups through clinical data and postoperative return data collection.The multi-dimensional analysis and summary was also performed to guide the choice of the optimal treatment plan.Result: Our analysis shows trivial differences in the baseline data of the two groups.For the biomedical indicators,except for the diameter of the ascending aorta,the difference is not statistically significant.In terms of total hospitalization time,total hospitalization cost,mechanical ventilation time,cardiopulmonary bypass time,and ascending aorta occlusion time,the ascending aortic angioplasty shows better results than ascending aortic replacement;in the quality of life index,patients of both surgical procedures has no significant differences in action ability,self-care ability,daily activity ability,pain status,and anxiety.However,the self-evaluation of life quality of patients with angioplasty is higher,and there is no significant difference in the incidence of long-term adverse events between the two groups.Conclusion: For senior patients aged 65 years and older,when the ascending aorta dilatation is between 40-55 mm,the lesion position is above the aortic sinus,the left and right coronary openings are not significantly displaced,and the aortic arch and its distal end are not involved,both surgical treatments can improve the biomedical index and have similar effects.The replacement treatment has a smaller annual rate of change in ascending aorta diameter.However,the angioplasty treatment outperforms the replacement treatment with lower hospitalization costs and better patient psychology,and is considered to be more suitable for current China’s health concept and the optimal allocation of resources.Based on these considerations,we recommend the aortic angioplasty treatment.