Kazui Toshinobu, Mitsunaga Yoshino, Fukuhiro Yoshiaki, Nakajima Takayuki, Okabayashi Hitoshi
Department of Cardiovascular Surgery, Memorial Heart Center, Iwate Medical University, Morioka, Japan.
Ann Thorac Cardiovasc Surg. 2008 Oct;14(5):339-42.
We report a reoperative case in which a Valsalva graft was utilized on a 64-year-old woman who had previously undergone emergency repair of a DeBakey type I acute aortic dissection. On follow-up computed tomography (CT), she was found to have pseudoaneurysms of both proximal and distal anastomoses. We performed valve-sparing aortic root replacement (VSRR) with the reimplantation technique and total arch replacement, since we felt that a graft with pseudosinuses helps to prevent torsion of the coronary arteries. The postoperative course was uneventful, and postoperative echocardiography revealed no significant aortic valve regurgitation. The pathology results raised the hypothesis that pseudoaneurysm formation might have been related to the use of gelatin-resorcinol-formaldehyde (GRF) glue at the time of the initial intervention.
我们报告了一例再次手术病例，该病例为一名64岁女性，她曾接受过DeBakey I型急性主动脉夹层的急诊修复，此次再次手术使用了Valsalva移植物。在随访计算机断层扫描（CT）时，发现她的近端和远端吻合口均有假性动脉瘤。我们采用保留瓣膜的主动脉根部置换术（VSRR）并结合再植入技术以及全弓置换术，因为我们认为带有假窦的移植物有助于防止冠状动脉扭转。术后病程平稳，术后超声心动图显示无明显主动脉瓣反流。病理结果提出了一个假设，即假性动脉瘤的形成可能与初次干预时使用明胶 - 间苯二酚 - 甲醛（GRF）胶水有关。
