Belov Iu V, Bogopol'skaia O M, Gens A P
Khirurgiia (Mosk). 2004(2):37-42.
In long-term period after resection of aorta coarctation, 9-14% patients developed aortic aneurysms, one third of them localized in the ascending aorta. From 146 patients operated on for aneurysm of the ascending aorta, 3 had aortic coarctation. In 2 patients aneurysms of the ascending aorta formed late after resection of the coarctation, the third patient was hospitalized with clinical picture of cardiac insufficiency at terminal stage due to coarctation of the aorta and a giant aneurysm of the ascending aorta with significant aortic insufficiency. The patients underwent successful surgeries: 1) ascending aorta grafting; 2) aortic valve and ascending aorta grafting by Bentallo de Bono method; 3) aortic valve and ascending aorta grafting by Bentallo de Bono method with bypass of descending aorta from the conduit. Cystic medianecrosis and two-volume aortic valve were revealed in all the patients. It is concluded that patients after surgery for coarctation of the aorta require long-term follow-up to defect cardiovascular complications early.
在主动脉缩窄切除术后的长期随访中，9%至14%的患者发生了主动脉瘤，其中三分之一位于升主动脉。在146例接受升主动脉瘤手术的患者中，有3例曾有主动脉缩窄。2例患者的升主动脉瘤在缩窄切除术后晚期形成，第3例患者因主动脉缩窄和伴有严重主动脉瓣关闭不全的升主动脉巨大动脉瘤而以终末期心力衰竭的临床表现入院。这些患者均成功接受了手术：1）升主动脉移植；2）采用Bentallo de Bono法进行主动脉瓣和升主动脉移植；3）采用Bentallo de Bono法进行主动脉瓣和升主动脉移植并通过管道绕过降主动脉。所有患者均发现有囊性中层坏死和二叶式主动脉瓣。结论是，主动脉缩窄手术后的患者需要长期随访以便早期发现心血管并发症。
