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复杂主动脉缩窄修复的两阶段混合方法。

Two stage hybrid approach for complex aortic coarctation repair.

作者信息

Koletsis Efstratios, Ekonomidis Stella, Panagopoulos Nikolaos, Tsaousis George, Crockett James, Panagiotou Matthew

机构信息

Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece.

出版信息

J Cardiothorac Surg. 2009 Feb 24;4:10. doi: 10.1186/1749-8090-4-10.

Abstract

BACKGROUND

Management of an adult patient with aortic coarctation and an associated cardiac pathology poses a great surgical challenge since there are no standard guidelines for the therapy of such complex pathology. Debate exists not only on which lesion should be corrected first, but also upon the type and timing of the procedure. Surgery can be one- or two-staged. Both of these strategies are accomplice with elevate morbidity and mortality.

CASE REPORT

In the face of such an extended surgical approach, balloon dilatation seems preferable for treatment of severe aortic coarctation.We present an adult male patient with aortic coarctation combined with ascending aorta aneurysm and concomitant aortic valve regurgitation. The aortic coarctation was corrected first, using percutaneous balloon dilatation; and in a second stage the aortic regurgitation and ascending aorta aneurysm was treated by Bentall procedure. The patients' postoperative period was uneventful. Three years after the operation he continues to do well.

摘要

背景

对于患有主动脉缩窄及相关心脏病变的成年患者,其治疗是一项巨大的外科挑战,因为目前尚无针对此类复杂病变的标准治疗指南。不仅对于应首先纠正哪种病变存在争议,而且对于手术的类型和时机也存在争议。手术可以是一期或二期进行。这两种策略都伴随着发病率和死亡率的升高。

病例报告

面对如此复杂的手术方式,球囊扩张术似乎更适合治疗严重主动脉缩窄。我们报告一例成年男性患者,患有主动脉缩窄合并升主动脉瘤及主动脉瓣反流。首先采用经皮球囊扩张术纠正主动脉缩窄;二期通过Bentall手术治疗主动脉瓣反流和升主动脉瘤。患者术后恢复顺利。术后三年他情况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb6f/2652448/c1023233941f/1749-8090-4-10-1.jpg

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