Clinical Experience Of 15 Cases Of Aortic Valve Disease Complicated With Ascending Aortic Dilation

Objective: To analyze the choice of surgical indications for aortic valve disease with ascending aortic aneurysm and the effect of Wheat operation,and to summarize the relevant clinical experience.Methods:From January 2014 to January 2019,15 patients with aortic valve disease and ascending aortic aneurysm underwent aortic valve replacement and wheat operation in our hospital(Second Hospital of Hebei Medical University).The clinical data were retrospectively analyzed.There were 10(66.6%)males and 5(33.3%)females,aged 34-68 years,with an average age of 55.4±8.61 years.The average age of males was 53.1±9.45 years.The average age of females was 60±6.12 years.There were 4 cases of smoking,5 cases of hypertension before operation,4 cases of coronary heart disease,1 case of diabetes and 1 case of pulmonary infection.Among them,3 cases were aortic stenosis,4 cases were aortic insufficiency,and 8 cases were aortic stenosis with insufficiency.There were 5 cases of aortic valve bicuspid deformity.Results:All the 15 patients were cured and discharged from hospital.One patient had difficulty in hemostasis due to excessive bleeding during operation.He was treated with gauze packing and delayed chest closure for 72 hours.After less drainage,gauze was removed to stop bleeding and close the chest.After that,he was cured and discharged.Fifteen patients with Wheat operation were hospitalized for 7-19 days with an average of 11.06±3.82 days;tracheal intubation for 15-134 hours with an average of 27.2 ±29.94 hours;ICU stay for 2-9 days with an average of 2.8 ±1.82 days;operation time for 423-830 minutes with an average of 362 ±83.06 minutes;cardiopulmonary bypass time for 90-370 minutes with an average of 165.2 ±69.78 minutes;cardiac block time for 70-310 minutes with an average of 120.4 ±58.82 minutes;The circulatory time was 20-92 minutes,with an average of 44.53 ±21.03 minutes.Conclusions:1.Patients with aortic valvular disease complicated with ascending aortic aneurysm often have complex etiology and are prone to induce other diseases,which belongs to a high-risk disease.Therefore,wheat operation is recommended when the diameter of ascending aorta is more than 45 mm.The patients can achieve more significant surgical results.2.At present,there are still some controversies about the surgical methods for ascending aortic aneurysms associated with different aortic valve lesions.The age of patients and the dilatation of ascending aorta should be taken into account in the selection of surgical procedures.3.Through the results of this study,we found that wheat operation can be used in patients with aortic valvular lesions and ascending aortic aneurysms to scientifically evaluate the condition,correctly select the operative scheme and do a good job of post-operative management,which can effectively improve the quality of life of patients and achieve better clinical results.