Nappi G, Cooley D A
G Ital Cardiol. 1977;7(11):1105-12.
Aortic valvotomy, aortic valve replacement, resection of the subaortic membrane and aortic patch angioplasty do not always provide satisfactory relief of left ventricular outflow tract obstruction. From August 1975 through January 1977, 15 patients underwent creation of a left ventricular vent by means of a Dacron fabric conduit containing a heterograft valve going from the left ventricle to the supraceliac portion of the abdominal aorta (Cooley's point). All patients had valvular, subvalvular, supravalvular aortic stenosis, or combined defects. One patient had severe hemolytic anemia following aortic valve replacement. Eleven of our 15 patients had undergone one or more previous surgical procedures for relief of aortic stenosis. The operative mortality has been one patient. At postoperative catheterization, there was a normalization of pressure gradients, and the blood flow through the conduit was 40% of the cardiac output. An interesting case of supravalvular aortic stenosis associated with stenosis of the vessels of the arch is presented.
主动脉瓣切开术、主动脉瓣置换术、主动脉瓣下隔膜切除术和主动脉补片血管成形术并不总能令人满意地缓解左心室流出道梗阻。1975年8月至1977年1月,15例患者通过一条含异种移植瓣膜的涤纶织物导管建立左心室引流,该导管从左心室通向腹主动脉的腹腔动脉以上部分(库利点)。所有患者均患有瓣膜性、瓣膜下、瓣膜上主动脉狭窄或合并缺陷。1例患者在主动脉瓣置换术后出现严重溶血性贫血。我们的15例患者中有11例曾接受过一次或多次缓解主动脉狭窄的外科手术。手术死亡率为1例患者。术后心导管检查时,压力阶差恢复正常,通过导管的血流量为心输出量的40%。本文介绍了1例合并主动脉弓血管狭窄的瓣膜上主动脉狭窄的有趣病例。