Sugiura T, Takahara Y, Sudo Y, Murayama H, Sezaki T, Nakamura T
Department of Cardiovascular Surgery, Tsurumai Hospital, Chiba, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Oct;39(10):1918-22.
Two reoperative cases of annuloaortic ectasia are reported. Since they have problems such as adhesion and friability of tissues, bleeding from each anastomosed sites must be watched carefully. Especially, anastomoses of aortic annulus and the composite graft, coronary ostia and the interposed conduit are important. Appropriate anastomosis of aortic annulus needs flexibility at the proximal edge of the composite graft. It can be achieved by sewing Björk-Shiley prosthetic valve about 5 mm distant from the proximal edge of the composite graft. Cabrol's method is good for anastomoses of coronary ostia because easily visualized and less stressed anastomoses can be performed. Therefore Cabrol's method with flexible edge of the composite graft at the proximal site is a useful technique in the reoperation of annuloaortic ectasia.
报告了两例主动脉瓣环扩张再次手术的病例。由于存在组织粘连和脆弱等问题,必须密切观察每个吻合部位的出血情况。特别是,主动脉瓣环与复合移植物的吻合、冠状动脉开口与置入管道的吻合很重要。主动脉瓣环的适当吻合需要复合移植物近端边缘具有灵活性。这可以通过将 Björk-Shiley 人工瓣膜缝在距复合移植物近端边缘约 5 毫米处来实现。卡布罗尔法适用于冠状动脉开口的吻合,因为可以进行易于可视化且压力较小的吻合。因此,在近端部位采用复合移植物边缘灵活的卡布罗尔法是主动脉瓣环扩张再次手术中的一种有用技术。