Nakano S, Matsuda H, Shimazaki Y, Taniguchi K, Kaneko M, Ueda T, Mori T, Kawashima Y
First Department of Surgery, Osaka University Medical School, Japan.
Eur J Cardiothorac Surg. 1992;6(7):347-9. doi: 10.1016/1010-7940(92)90170-3.
To avoid the problem of valve prosthesis/patient mismatch in the late postoperative period, we have adopted patch enlargement of the small aortic annulus in 33 patients having undergone aortic valve replacement since 1975, when the aortic annulus could not accept a large enough prosthesis. The mean age was 40 years, including 2 children aged 4. The technique of patch enlargement utilized was Nicks' method wherein the incision does not extend onto the mitral leaflet. In 31 adult patients, the aortic annulus before enlargement ranged in diameter from 18 to 24 mm with an average of 20.8 mm. After enlargement, the diameter of the annulus was 25.0 mm on average. In 2 children, the mean diameter of the annulus was enlarged from 16.5 mm to 20.5 mm. There were 2 early deaths in the initial series and 2 late deaths. Patch enlargement of the small aortic annulus is a simple, safe, and effective adjunct permitting the insertion of a valve one or two sizes larger than that which could be accommodated by the native annulus.
为避免术后晚期人工瓣膜/患者不匹配的问题，自1975年以来，我们对33例接受主动脉瓣置换术的患者采用了小主动脉瓣环补片扩大术，当时主动脉瓣环无法容纳足够大的人工瓣膜。平均年龄为40岁，其中包括2名4岁儿童。采用的补片扩大技术是尼克（Nicks）法，即切口不延伸至二尖瓣叶。在31例成年患者中，扩大前主动脉瓣环直径为18至24毫米，平均为20.8毫米。扩大后，瓣环平均直径为25.0毫米。在2名儿童中，瓣环平均直径从16.5毫米扩大至20.5毫米。最初的系列中有2例早期死亡和2例晚期死亡。小主动脉瓣环补片扩大术是一种简单、安全且有效的辅助方法，可允许植入比天然瓣环所能容纳的瓣膜大一号或两号尺寸的瓣膜。
