Аннотация
Патология аортального клапана у пациентов детского возраста в большинстве случаев (включая его протезирование) подразумевает многоэтапное хирургическое лечение. Очевидно, что наибольшее предпочтение следует отдавать той стратегии, при которой пациент будет подвержен минимальному количеству повторных вмешательств в течение своей последующей жизни. До настоящего времени не проведено ни одного многоцентрового исследования, направленного на оценку существующих методик. Эволюция хирургических подходов и их различия между клиниками также не позволяют провести полноценный сравнительный анализ. В данной статье представлен краткий обзор научных публикаций, посвященных хирургической коррекции врожденной патологии аортального клапана, c оценкой преимуществ и недостатков различных методик.
Литература
- El Khoury G., Glineur D., Rubay J., Verhelst R., D’Acoz, d’Udekem Y., Poncelet A. et al. Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Curr. Opin. Cardiol. 2005; 20 (2): 115–21. DOI: 10.1097/01.hco.0000153951.31887.a6
- Formigari R., Toscano A., Giardini A., Gargiulo G., Di Donato R., Picchio F.M. et al. Prevalence and predictors of neoaortic regurgitation after arterial switch operation for transposition of the great arteries. J. Thorac. Cardiovasc. Surg. 2003; 126 (6): 1753–9. DOI: 10.1016/S0022-5223(03)01325-4
- D’Udekem Y. Aortic valve surgery in children. Heart. 2011; 97 (14): 1182–9. DOI: 10.1136/hrt.2009.190520
- Lillehei C.W., Dewall R.A., Gott V.L., Varco R.L. The direct vision correction of calcific aortic stenosis by means of a pump-oxygenator and retrograde coronary sinus perfusion. Dis. Chest. 1956; 30 (2): 123–32.
- Lababidi Z., Columbia M.D. Aortic balloon valvuloplasty. Am. Heart J. 1983; 106 (4): 751–2.
- Donald J.S., Konstantinov I.E. Surgical aortic valvuloplasty versus balloon aortic valve dilatation in children. World J. Pediatr. Congenit. Heart Surg. 2016; 7 (5): 583–91. DOI: 10.1177/2150135116651091
- Maskatia S.A., Ing F.F., Justino H., Crystal M.A., Mullins C.E., Mattamal R.J. et al. Twenty-five year experience with balloon aortic valvuloplasty for congenital aortic stenosis. Am. J. Cardiol. 2011; 108 (7): 1024–8. DOI: 10.1016/j.amjcard. 2011.05.040
- McCrindle B.W., Blackstone E.H., Williams W.G., Sittiwangkul R., Spray T.L., Azakie A. et al. Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis? Circulation. 2001; 104 (12 Suppl. 1): I152–8. DOI: 10.1161/hc37t1.094837
- Agnoletti G., Raisky O., Boudjemline Y., Ou P., Bonnet D., Sidi D. et al. Neonatal surgical aortic commissurotomy: predictors of outcome and long-term results. Ann. Thorac. Surg. 2006; 82 (5): 1585–92. DOI: 10.1016/j.athoracsur.2006.05.049
- Siddiqui J., Brizard C.P., Galati J.C., Iyengar A.J., Hutchinson D., Konstantinov I.E. et al. Surgical valvotomy and repair for neonatal and infant congenital aortic stenosis achieves better results than interventional catheterization. J. Am. Coll. Cardiol. 2013; 62 (22): 2134–40. DOI: 10.1016/J.JACC.2013.07.052
- Prijic S.M., Vukomanovic V.A., Stajevic M.S., Bjelakovic B.B., Zdravkovic M.D., Sehic I.N. et al. Balloon dilation and surgical valvotomy comparison in non-critical congenital aortic valve stenosis. Pediatr. Cardiol. 2015; 36 (3): 616–24. DOI: 10.1007/s00246-014-1056-6
- Alexiou C., Langley S.M., Dalrymple-Hay M.J., Salmon A.P., Keeton B.R., Haw M.P. et al. Open commissurotomy for critical isolated aortic stenosis in neonates. Ann. Thorac. Surg. 2001; 71 (2): 489–93. DOI: 10.1016/S0003-4975(00)02232-3
- Miyamoto T., Sinzobahamvya N., Wetter J., Kallenberg R., Brecher A.M., Asfour B. et al. Twenty years experience of surgical aortic valvotomy for critical aortic stenosis in early infancy. Eur. J. Cardiothorac. Surg. 2006; 30 (1): 35–40. DOI: 10.1016/j.ejcts.2006.03.050
- Hraška V., Sinzobahamvya N., Haun C., Photiadis J., Arenz C., Schneider M. et al. The long-term outcome of open valvotomy for critical aortic stenosis in neonates. Ann. Thorac. Surg. 2012; 94 (5): 1519–26. DOI: 10.1016/j.athoracsur. 2012.03.056
- D’Udekem Y., Siddiqui J., Seaman C.S., Konstantinov I.E., Galati J.C., Cheung M.M.H. et al. Long-term results of a strategy of aortic valve repair in the pediatric population. J. Thorac. Cardiovasc. Surg. 2013; 145 (2): 461–9. DOI: 10.1016/j.jtcvs.2012.11.033
- Rossi R.I., Manica J.L.L.L., Petraco R., Scott M., Piazza L., Machado P.M. Balloon aortic valvuloplasty for congenital aortic stenosis using the femoral and the carotid artery approach: a 16-year experience from a single center. Catheter Cardiovasc. Interv. 2011; 78 (1): 84–90. DOI: 10.1002/ccd.22938
- Soulatges C., Momeni M., Zarrouk N., Moniotte S., Carbonez K., Barrea C. et al. Long-term results of balloon valvuloplasty as primary treatment for congenital aortic valve stenosis: a 20-year review. Pediatr. Cardiol. 2015; 36 (6): 1145–52. DOI: 10.1007/s00246-015-1134-4
- Brown J.W., Rodefeld M.D., Ruzmetov M., Eltayeb O., Yurdakok O., Turrentine M.W. Surgical valvuloplasty versus balloon aortic dilation for congenital aortic stenosis: are evidence-based outcomes relevant? Ann. Thorac. Surg. 2012; 94 (1): 146–55. DOI: 10.1016/j.athoracsur.2012.02.054
- Brown D.W., Dipilato A.E., Chong E.C., Lock J.E., McElhinney D.B. Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis: intermediate and late follow-up. J. Am. Coll. Cardiol. 2010; 56 (21): 1740–9. DOI: 10.1016/j.jacc.2010.06.040
- Alsoufi B., Al-Halees Z., Manlhiot C., McCrindle B.W., AlAhmadi M., Sallehuddin A. et al. Mechanical valves versus the Ross procedure for aortic valve replacement in children: Propensity-adjusted comparison of long-term outcomes. J. Thorac. Cardiovasc. Surg. 2009; 137 (2): 362–70.e9. DOI: 10.1016/j.jtcvs.2008.10.010
- Alsoufi B., Manlhiot C., McCrindle B.W., Canver C.C., Sallehuddin A., Al-Oufi S. et al. Aortic and mitral valve replacement in children: is there any role for biologic and bioprosthetic substitutes? Eur. J. Cardiothorac. Surg. 2009; 36 (1): 84–90. DOI: 10.1016/j.ejcts.2009.02.048
- Brancaccio G., Polito A., Hoxha S., Gandolfo F., Giannico S., Amodeo A. et al. The Ross procedure in patients aged less than 18 years: the midterm results. J. Thorac. Cardiovasc. Surg. 2014; 147 (1): 383–8. DOI: 10.1016/j.jtcvs.2013.02.037
- Mavroudis C., Mavroudis C.D., Jacobs J.P. The Ross, Konno, and Ross–Konno operations for congenital left ventricular outflow tract abnormalities. Cardiol. Young. 2014; 24 (6): 1121–33. DOI: 10.1017/S1047951114002042
- Elkins R.C., Thompson D.M., Lane M.M., Elkins C.C., Peyton M.D., Sade R.M. et al. Ross operation: 16-year experience. J. Thorac. Cardiovasc. Surg. 2008; 136 (3): 623–30.e5. DOI: 10.1016/j.jtcvs.2008.02.080
- Hörer J., Hanke T., Stierle U., Takkenberg J.J.M., Bogers A.J.J.C., Hemmer W. et al. Neoaortic root diameters and aortic regurgitation in children after the ross operation. Ann. Thorac. Surg. 2009; 88 (2): 594–600. DOI: 10.1016/j.athoracsur.2009.04.077
- Takkenberg J.J.M., van Herwerden L.A., Galema T.W., Bekkers J.A., Kleyburg-Linkers V.A., Eijkemans M.J., Bogers A. Serial echocardiographic assessment of neo-aortic regurgitation and root dimensions after the modified Ross procedure. J. Heart Valve Dis. 2006; 15 (1): 100–6.
- Alsoufi B., Manlhiot C., Fadel B., Al-Ahmadi M., Tamim M., McCrindle B.W. et al. The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation. Eur. J. Cardiothorac. Surg. 2010; 38 (5): 547–55. DOI: 10.1016/j.ejcts.2010.03.025
- Pasquali S.K., Cohen M.S., Shera D., Wernovsky G., Spray T.L., Marino B.S. The relationship between neo-aortic root dilation, insufficiency, and reintervention following the Ross procedure in infants, children, and young adults. J. Am. Coll. Cardiol. 2007; 49 (17): 1806–12. DOI: 10.1016/j.jacc.2007.01.071
- Chantos E.I., Hanke T., Stierle U., Robinson D.R., Bogers A.J.J.C., Hemmer W. et al. Autograft reinforcement to preserve autograft function after the ross procedure a report from the german-dutch ross registry. Circulation. 2009; 120 (Suppl. 1): 146–55. DOI: 10.1161/CIRCULATIONAHA. 108.843391
- Brown J.W., Ruzmetov M., Shahriari A.P., Rodefeld M.D., Mahomed Y., Turrentine M.W. Modification of the Ross aortic valve replacement to prevent late autograft dilatation. Eur. J. Cardiothorac. Surg. 2010; 37 (5): 1002–7. DOI: 10.1016/j.ejcts.2009.12.012
- Ungerleider R.M., Ootaki Y., Shen I., Welke K.F. Modified Ross procedure to prevent autograft dilatation. Ann. Thorac. Surg. 2010; 90 (3): 1035–7. DOI: 10.1016/j.athoracsur.2009.09.078
- Alsoufi B., Al-Halees Z., Manlhiot C., Awan A., Al-Ahmadi M., McCrindle B.W. et al. Intermediate results following complex biventricular repair of left ventricular outflow tract obstruction in neonates and infants. Eur. J. Cardiothorac. Surg. 2010; 38 (4): 431–8. DOI: 10.1016/j.ejcts.2010.02.035
- Шаталов К.В., Абдуразаков М.А., Муратов Р.М., Арнаутова И.В., Джиджихия К.М. Замена аортального клапана у детей: операция Ross или протезирование механическим клапаном? Грудная и сердечно-сосудистая хирургия. 2020; 62 (4): 318–24. DOI: 10.24022/0236-2791-2020-62- 4-318-324
- Schlein J., Ebner B.E., Geiger R., Simon P., Wollenek G., Moritz A. et al. Long-term outcomes after the paediatric Ross and Ross–Konno procedures. Interact. Cardiovasc. Thorac. Surg. 2021; 33 (3): 455–61. DOI: 10.1093/icvts/ivab093
- Alsoufi B., Al-Halees Z., Manlhiot C., McCrindle B.W., Kandeel M., Al-Joufan M. et al. Superior results following the Ross procedure in patients with congenital heart disease. J. Heart Valve Dis. 2010; 19 (3): 269–77; discussion 278.
- Takkenberg J.J.M., Klieverik L.M.A., Schoof P.H., van Suylen R.J., van Herwerden L.A., Zondervan P.E. et al. The Ross procedure: a systematic review and meta-analysis. Circulation. 2009; 119 (2): 222–8. DOI: 10.1161/CIRCULATIONAHA.107.726349
- Duran C.G. Reconstructive techniques for rheumatic aortic valve disease. J. Card. Surg. 1988; 3 (1): 23–8. DOI: 10.1111/j.1540-8191.1988.tb00214.x
- De Kerchove L., Mastrobuoni S., Froede L., Tamer S., Boodhwani M., Van Dyck M. et al. Variability of repairable bicuspid aortic valve phenotypes: Towards an anatomical and repair-oriented classification. Eur. J. Cardiothorac. Surg. 2019; 56 (2): 351–9. DOI: 10.1093/ejcts/ezz033
- Cuttone F., Alacoque X., Leobon B., Karsenty C., Guitarte A., Dulac Y. et al. Aortic valve reconstruction in children: a new string to our bow. Arch. Cardiovasc. Dis. 2019; 112 (11): 653–6. DOI: 10.1016/j.acvd.2019.09.002
- Lansac E., de Kerchove L. Aortic valve repair techniques: State of the art. Eur. J. Cardiothorac. Surg. 2018; 53 (6): 1101–7. DOI: 10.1093/ejcts/ezy176
- Polimenakos A.C., Sathanandam S., Blair C., Elzein C., Roberson D., Ilbawi M.N. Selective tricuspidization and aortic cusp extension valvuloplasty: outcome analysis in infants and children. Ann. Thorac. Surg. 2010; 90 (3): 839–47. DOI: 10.1016/j.athoracsur.2010.05.052
- Pretre R., Kadner A., Dave H., Bettex D., Genoni M. Tricuspidisation of the aortic valve with creation of a crown-like annulus is able to restore a normal valve function in bicuspid aortic valves. Eur. J. Cardiothorac. Surg. 2006; 29 (6): 1001–6. DOI: 10.1016/j.ejcts.2006.01.068
- Mastrobuoni S., El Khoury G. Aortic valve repair and Ross operation in children: the importance of patient selection and surgical technique. Eur. J. Cardiothorac. Surg. 2016; 49 (3): 892–3. DOI: 10.1093/ejcts/ezv236
- Лукьянов А.А., Горбатых Ю.Н., Богачёв-Прокофьев А.В., Наберухин Ю.Л., Омельченко А.Ю., Хапаев Т.С. и др. Эффективность открытой комиссуротомии в хирургическом лечении стеноза аортального клапана у пациентов педиатрической группы. Патология кровообращения и кардиохирургия. 2015; 19 (1): 72–7.
- Halees Z., Shahid M., Sanei A., Sallehuddin A., Duran C. Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve? Eur. J. Cardiothorac. Surg. 2005; 28 (2): 200–5. DOI: 10.1016/j.ejcts.2005.04.041
- Polimenakos A.C., Sathanandam S., El Zein C., Barth M.J., Higgins R.S.D., Ilbawi M.N. Aortic cusp extension valvuloplasty with or without tricuspidization in children and adolescents: long-term results and freedom from aortic valve replacement. J. Thorac. Cardiovasc. Surg. 2010; 139 (4): 933–41. DOI: 10.1016/j.jtcvs.2009.12.015
- Ozaki S., Kawase I., Yamashita H., Uchida S., Nozawa Y., Takatoh M. et al. A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium. J. Thorac. Cardiovasc. Surg. 2014; 147 (1): 301–6. DOI: 10.1016/J.JTCVS.2012.11.012
- ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease. Circulation. 2006; 114 (5).
- Cameron D., Vricella L. Valve-sparing aortic root replacement in children. Oper. Tech. Thorac. Cardiovasc. Surg. 2013; 18 (1): 2–14. DOI: 10.1053/j.optechstcvs.2013.04.001
- Patel N.D., Arnaoutakis G.J., George T.J., Allen J.G., Alejo D.E., Dietz H.C. et al. Valve-sparing aortic root replacement in children: intermediate-term results. Interact. Cardiovasc. Thorac. Surg. 2011; 12 (3): 415–9. DOI: 10.1510/icvts.2010.255596
- Roberts C.S., Roberts W.C. Dissection of the aorta associated with congenital malformation of the aortic valve. J. Am. Coll. Cardiol. 1991; 17 (3): 712–6. DOI: 10.1016/S0735- 1097(10)80188-3
- Conaglen P., Luthra S., Skillington P., Bodian C.A., Luehr M., Luozzo G.D. et al. Comparison of reduction ascending aortoplasty and ascending aortic replacement for bicuspid valve related aortopathy in young adult patients undergoing aortic valve replacement – long-term follow-up. Heart Lung Circ. 2009; 18 (5): 337–42. DOI: 10.1016/j.hlc.2009.03.049
- Buratto E., Konstantinov I.E. Aortic valve surgery in children. J. Thorac. Cardiovasc. Surg. Published online 2020: 1–8. DOI: 10.1016/j.jtcvs.2020.06.145
- Galoin-Bertail C., Capderou A., Belli E., Houyel L. The midterm outcome of primary open valvotomy for critical aortic stenosis in early infancy – a retrospective single center study over 18 years. J. Cardiothorac. Surg. 2016; 11 (1): 116. DOI: 10.1186/s13019-016-0509-9
- Wang K., Zhang H., Jia B. Current surgical strategies and techniques of aortic valve diseases in children. Transl. Pediatr. 2018; 7 (2): 83–90. DOI: 10.21037/tp.2018.02.03
- Han R.K., Gurofsky R.C., Lee K.J., Dipchand A.I., Williams W.G., Smallhorn J.F. et al. Outcome and growth potential of left heart structures after neonatal intervention for aortic valve stenosis. J. Am. Coll. Cardiol. 2007; 50 (25): 2406–414. DOI: 10.1016/j.jacc.2007.07.082
- Poncelet A.J., El Khoury G., De Kerchove L., Sluysmans T., Moniotte S., Momeni M. et al. Aortic valve repair in the paediatric population: insights from a 38-year single-centre experience. Eur. J. Cardiothorac. Surg. 2017; 51 (1): 43–9. DOI: 10.1093/ejcts/ezw259
- McMullan D.M., Oppido G., Davies B., Kawahira Y., Cochrane A.D., d’Udekem d’Acoz Y. et al. Surgical strategy for the bicuspid aortic valve: tricuspidization with cusp extension versus pulmonary autograft. J. Thorac. Cardiovasc. Surg. 2007; 134 (1): 90–8. DOI: 10.1016/j.jtcvs.2007.01.054
- Bacha E.A., McElhinney D.B., Guleserian K.J., Colan S.D., Jonas R.A., del Nido P.J. et al. Surgical aortic valvuloplasty in children and adolescents with aortic regurgitation: acute and intermediate effects on aortic valve function and left ventricular dimensions. J. Thorac. Cardiovasc. Surg. 2008; 135 (3): 552–9.e3. DOI: 10.1016/j.jtcvs.2007.09.057
- Schäfers H.J.J. The 10 commandments for aortic valve repair. Innov. Technol. Tech. Cardiothorac. Vasc. Surg. 2019; 14 (3): 188–98. DOI: 10.1177/1556984519843909
- Mimic B., Wiggins L., Bonello B., Marek J., Ilic S. Promising short term outcomes of aortic valve neo-tricuspidalization in children and young adults. Abstracts of the jointmeeting of the European Congenital Heart Surgeons Association and the World Society for Pediatric and Congenital Heart Surgery, Sofia. World J. Pediatr. Congenit. Hear Surg. 2019; 10 (6): NP6. DOI: 10.1177/2150135119869003
- Baird C.W., Cooney B., Chávez M., Sleeper L.A., Marx G.R., del Nido P.J. Congenital aortic and truncal valve reconstruction using the Ozaki technique: short-term clinical results. J. Thorac. Cardiovasc. Surg. 2021; 161: 1567–77. DOI: 10.1016/j.jtcvs.2020.01.087
- Базылев В.В., Черногривов И.Е., Бофанов Д.А., Бабуков Р.М., Гамзаев А.Б., Начкебия Б.Р. и др. Результаты выполнения неотрикуспидализации аортального клапана, или операции Озаки, у детей в зависимости от возраста. Детские болезни сердца и сосудов. 2021; 18 (3): 184–98. DOI: 10.24022/1810-0686-2021-18-3-184-198
- Karamlou T., Pettersson G., Nigro J.J. Commentary: a pediatric perspective on the Ozaki procedure. J. Thorac. Cardiovasc. Surg. 2021; 161: 1582–3. DOI: 10.1016/j.jtcvs.2020.02.128
- Konstantinov I.E., Naimo P.S., Buratto E. Commentary: Ozaki valve reconstruction in children: is it still a valve replacement? J. Thorac. Cardiovasc. Surg. 2021; 161 (5): 1579–81. DOI: 10.1016/J.JTCVS.2020.02.030
- Marathe S.P., Chávez M., Sleeper L.A., Marx G., del Nido P.J., Baird C.W. Modified Ozaki procedure including annular enlargement for small aortic annuli in young patients. Ann. Thorac. Surg. 2020; 110 (4): 1364–71. DOI: 10.1016/j.athoracsur.2020.04.025
Об авторах
Матаев Виктор Сергеевич, канд. мед. наук, науч. сотр.;
ORCID
