Péterffy Arpád, Jagamos Endre, Szentgyörgyi Lajos, Vágvölgyi Attila, Szerafin Tamás
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Altalános Orvostudomány Kar, Szívsebészeti Klinika.
Orv Hetil. 2003 Feb 16;144(7):313-6.
This is a case report of a 52 year-old male patient with severe calcific aortic valve stenosis, associated with extended circular calcification of the ascending aorta and the aortic arch. Six months ago the patient underwent an explorative sternotomy in another institute, but the aortic valve replacement was not performed regarding the great risk of the porcelain aorta. The patient's complaints became more severe, so the authors recommended the excision both of the stenotic aortic valve and the calcified ascending aorta and replacement with a mechanical valve and vascular prosthesis. The operation was performed in deep hypothermia and total circulatory arrest with help of cardiopulmonary bypass. The calcified ascending aorta was excised without crossclamping. The vascular graft used for replacement of the ascending aorta was anastomosed to the proximal part of the aortic arch, then it was clamped and the extracorporal circulation was started again with rewarming of the patient. The aortic valve was replaced with a 21 mm St. Jude HP mechanical valve prosthesis in the usual manner. At last, the graft was anastomosed supracoronary to the proximal stump of the ascending aorta. Extracorporal circulation was discontinued without any difficulties. Apart from a few days of somnolence, the patient's recovery was uneventful, he was discharged from hospital on the 12th postoperative day. Three months after the surgery he had no complaints and returned to work without any problems.
这是一例关于一名52岁男性患者的病例报告，该患者患有严重的钙化性主动脉瓣狭窄，并伴有升主动脉和主动脉弓的环形钙化扩展。六个月前，患者在另一所机构接受了探查性胸骨切开术，但由于瓷化主动脉的巨大风险，未进行主动脉瓣置换术。患者的症状变得更加严重，因此作者建议切除狭窄的主动脉瓣和钙化的升主动脉，并用机械瓣膜和血管假体进行置换。手术在深低温和全循环停搏下借助体外循环进行。钙化的升主动脉在未进行阻断的情况下被切除。用于置换升主动脉的血管移植物与主动脉弓近端吻合，然后夹闭，随着患者复温再次开始体外循环。主动脉瓣以常规方式用21毫米圣犹达HP机械瓣膜假体置换。最后，移植物在冠状动脉上方与升主动脉近端残端吻合。体外循环顺利停止。除了几天的嗜睡外，患者恢复顺利，术后第12天出院。术后三个月，他没有任何不适，毫无问题地重返工作岗位。
