Klokocovnik Tomislav, Span Matjaz, Gregoric Igor D
Department of Cardiovascular Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia.
Heart Surg Forum. 2008;11(3):E181-3. doi: 10.1532/HSF98.20081029.
Abdominal aortic aneurysms (AAAs) are commonly associated with severe coronary artery disease, but the incidence of associated aortic valve disease and AAAs in the general population is not known. The standard approach for surgical repair of AAAs is a laparotomy, and for aortic valve repair, a full sternotomy; results of both approaches are well documented. However, when AAAs and aortic valve disease occur concomitantly and both are symptomatic, they should be repaired during a combined procedure, with the aortic valve repair performed first. We describe the case of a 75-year-old patient with a symptomatic infrarenal AAA and severe aortic valve stenosis. To avoid an extensive surgical incision and shorten the recovery period, we performed a combined procedure in which we replaced the aortic valve through a ministernotomy and repaired the AAA through a minilaparotomy. The postoperative period was uneventful, and the patient was discharged home 6 days after surgery.
腹主动脉瘤（AAAs）通常与严重冠状动脉疾病相关，但一般人群中主动脉瓣疾病与腹主动脉瘤并存的发生率尚不清楚。腹主动脉瘤手术修复的标准方法是开腹手术，而主动脉瓣修复则是全胸骨切开术；这两种方法的结果都有充分记录。然而，当腹主动脉瘤和主动脉瓣疾病同时出现且均有症状时，应在联合手术中进行修复，先进行主动脉瓣修复。我们描述了一名75岁有症状的肾下腹主动脉瘤和严重主动脉瓣狭窄患者的病例。为避免广泛的手术切口并缩短恢复期，我们进行了联合手术，通过微创胸骨切开术置换主动脉瓣，并通过微创剖腹术修复腹主动脉瘤。术后过程顺利，患者术后6天出院回家。
