Yoshikai Masaru, Ito Tsuyoshi, Ohnishi Hiroyuki, Kamohara Keiji, Fumoto Hideyuki, Furutachi Akira
Department of Cardiovascular Surgery, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, Fukuoka, 830-8577, Japan.
Surg Today. 2006;36(2):201-3. doi: 10.1007/s00595-005-3127-z.
Aortic root replacement after aortic valve replacement (AVR) is often complicated by bleeding around the aortic root, which increases the risk of morbidity and mortality, making it a technically challenging procedure. We describe a new technique of aortic root replacement designed to minimize bleeding around the aortic root. This surgical technique focuses on safe dissection and exposure of the aortic root to avoid inadvertent entry into the right atrium or right ventricle; on modifying the proximal anastomosis of the graft to the aortic annulus; and on performing a coronary artery reimplantation that achieves complete hemostasis at the suture lines. We performed aortic root replacement after AVR in four patients over a 4-year period, without encountering any bleeding around the aortic root.
主动脉瓣置换术（AVR）后进行主动脉根部置换术常常因主动脉根部周围出血而变得复杂，这增加了发病和死亡风险，使其成为一项技术上具有挑战性的手术。我们描述了一种旨在尽量减少主动脉根部周围出血的主动脉根部置换新技术。这种手术技术侧重于安全解剖和暴露主动脉根部以避免意外进入右心房或右心室；修改移植物与主动脉瓣环的近端吻合；以及进行冠状动脉再植入，以在缝合线处实现完全止血。我们在4年期间对4例患者进行了AVR后的主动脉根部置换术，未遇到主动脉根部周围的任何出血情况。
