Tsilimingas Nikolaos B, von Kodolitsch Yskert, Reiter Beate, Münzel Thomas, Meinertz Thomas
Clinic of Thoracic and Cardiovascular Surgery, University-Hospital Hamburg-Eppendorf, Hamburg, Germany.
J Heart Valve Dis. 2004 Sep;13(5):738-40.
The infection of aortic annular tissue is a life-threatening complication of aortic valve endocarditis, the survival of which is usually with immediate surgical intervention. Optimal surgical techniques include aortic valve replacement with an aortic or pulmonary homograft, and reconstruction of cardiac structures with autologous pericardium. Here, two cases are reported with extensive aortic root infection and partial left ventricular-aortic dehiscence, who underwent left ventricular outflow tract reconstruction using a rectus abdominis fascia patch and aortic valve replacement with a Carpentier-Edwards porcine bioprosthetic graft. Both patients did well perioperatively and for 10 years postoperatively. The results may encourage alternative surgical strategies to be used when aortic valve homografts or autologous pericardium are unavailable. Notably, autologous rectus fascia patches showed excellent performance in the reconstruction of left ventricular outflow tract destruction associated with aortic root abscess.
主动脉瓣环组织感染是主动脉瓣心内膜炎的一种危及生命的并发症,其存活通常需要立即进行手术干预。最佳手术技术包括使用主动脉或肺动脉同种异体移植物置换主动脉瓣,以及用自体心包重建心脏结构。本文报道了两例广泛主动脉根部感染和部分左心室-主动脉瓣环裂开的病例,他们接受了使用腹直肌筋膜补片重建左心室流出道和用Carpentier-Edwards猪生物瓣膜置换主动脉瓣的手术。两名患者围手术期及术后10年情况良好。当无法获得主动脉瓣同种异体移植物或自体心包时,这些结果可能会促使采用替代手术策略。值得注意的是,自体腹直肌筋膜补片在重建与主动脉根部脓肿相关的左心室流出道破坏方面表现出色。