Hata T, Fujiwara K, Furukawa H, Tsushima Y, Yoshitaka H, Kuinose M, Minami H, Ishida A, Tamura K, Totsugawa T, Kanemitsu H, Ozawa M
Department of Cardiovascular Surgery, Cardiovascular Center Kohsei General Hospital, Mihara, Japan.
Kyobu Geka. 2006 Apr;59(4):283-7.
Recent reports have shown that aortic valve replacement in elderly patients over 65 years with atherosclerotic aortic stenosis and a small aortic annulus is possible by using a small sized bioprosthesis (Carpentier-Edwards pericardial valve). Here we present out surgical technique. Firstly, the native calcified aortic valve was removed completely to gain total exposure of the surrounding aortic root and sinus of Valsalva like Bentall procedure. Secondly, a small sized bioprosthesis was implanted with intermittent noneverting mattress 2-0 sutures with spaghetti and small polytetrafluoroethylene (PTFE) felt. Aortic annulus is the dilated by inserting Hegar dilator sizing from 25 to 27 mm. Therefore, aortic valve replacement for small aortic annulus in intra- or supra-annular position should be easily accomplished. Good surgical results and hemodynamic state were achieved in 25 consecutive cases using this technique.
最近的报告显示，对于65岁以上患有动脉粥样硬化性主动脉瓣狭窄且主动脉瓣环较小的老年患者，使用小型生物假体（Carpentier-Edwards心包瓣膜）进行主动脉瓣置换是可行的。在此，我们展示我们的手术技术。首先，像Bentall手术一样，将天然钙化主动脉瓣完全移除，以充分暴露周围的主动脉根部和主动脉窦。其次，用2-0间断外翻褥式缝线、棉线和小的聚四氟乙烯（PTFE）垫片植入小型生物假体。通过插入尺寸从25至27毫米的Hegar扩张器来扩张主动脉瓣环。因此，在瓣环内或瓣环上位置为小主动脉瓣环进行主动脉瓣置换应该很容易完成。使用该技术的连续25例患者均取得了良好的手术效果和血流动力学状态。
