Rastan H, Koncz J
J Thorac Cardiovasc Surg. 1976 Jun;71(6):920-7.
Aortoventriculoplasty is a new method of treatment for left ventricular outflow tract obstructions. The concept is based on creating a surgical defect which is patched in such a way as to provide the largest possible outflow to the left ventricle. The incision of the aorta continues down as far as necessary, with the right ventricular wall, the aortic ring, and the septum being cut. Reconstruction with an inner Dacron patch on the septum is completed by replacing the aortic valve with an adequate prosthesis, covering the aortic incision with the same patch, and patching the right venticular opening with an outer patch. This method was used in 4 children with tunnel-like subaortic stenosis, 3 of whom had had unsuccessful previous surgical attempts. Other associated lesions including parachute mitral valve were also corrected during aortoventriculoplasty. Hemodynamic results were excellent following this operation. Two patients died postoperatively, one from advanced myocardial damage and progressive failure and the other from cerebral ischemia caused by insufficient retrograde perfusion through an aortic coarctation that was not repaired earlier. No arrhythmias were observed following the procedure. The other 2 patients are well 7 and 5 months postoperatively with excellent hemodynamic function.
主动脉心室成形术是一种治疗左心室流出道梗阻的新方法。其理念基于制造一个手术缺损，通过特定方式修补该缺损，以尽可能为左心室提供最大的流出道。主动脉切口根据需要向下延伸，同时切开右心室壁、主动脉环和室间隔。在室间隔上用涤纶补片进行重建，通过用合适的人工瓣膜替换主动脉瓣、用同一补片覆盖主动脉切口以及用外部补片修补右心室开口来完成。该方法用于4例隧道样主动脉瓣下狭窄患儿，其中3例先前手术尝试失败。在主动脉心室成形术期间，还对包括降落伞样二尖瓣等其他相关病变进行了矫正。术后血流动力学结果极佳。2例患者术后死亡，1例死于晚期心肌损伤和进行性衰竭，另1例死于因未早期修复的主动脉缩窄导致逆行灌注不足引起的脑缺血。术后未观察到心律失常。另外2例患者术后7个月和5个月情况良好，血流动力学功能极佳。
