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主动脉根部瘤的新主动脉根部重塑手术。

New aortic root remodeling surgery in aortic root aneurysm.

机构信息

Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.

出版信息

Ann Thorac Surg. 2010 Apr;89(4):1260-4. doi: 10.1016/j.athoracsur.2009.12.036.

Abstract

PURPOSE

We have introduced a new surgical technique for aortic root remodeling in aortic root aneurysm, comprised of aortic annuloplasty, reduction of sinus of Valsalva, and wrapping of the aortic root.

DESCRIPTION

At the level of the basal ring, the aortic annulus is fixed with the collar of a Gelweave Valsalva vascular graft (Vascutek, Ltd, Inchinnan, UK). After plication of the dilated sinuses of Valsalva from outside the aorta, the aortic root is wrapped with this prosthesis. The distal end of the graft and the transected aortic wall are sutured together with running sutures.

EVALUATION

Since September 2006, 10 patients suffering from aortic root aneurysm were successfully operated on using this technique. After a median follow-up of 20.7 months, there were no early deaths and no reoperations due to failure of remodeling surgery. Median diameter of the sinus of Valsalva was reduced from 49.5 mm to 34.0 mm. All patients showed aortic regurgitation of grade 0 or grade 1 at follow-up.

CONCLUSIONS

Long-term follow-up is necessary to prove the durability of this operation.

摘要

目的

我们介绍了一种用于主动脉根部瘤的主动脉根部重塑的新手术技术,包括主动脉瓣环成形术、窦部缩小术和主动脉根部包裹术。

描述

在基底环水平,用 Gelweave Valsalva 血管移植物(Vascutek,Ltd,Inchinnan,英国)的领圈固定主动脉瓣环。在经主动脉外部对扩张的窦部进行折叠之后,用这个假体包裹主动脉根部。移植物的远端和切开的主动脉壁用连续缝线缝合在一起。

评估

自 2006 年 9 月以来,使用该技术成功为 10 例主动脉根部瘤患者进行了手术。中位随访 20.7 个月后,无早期死亡,无因重塑手术失败而再次手术。窦部直径从 49.5mm 缩小至 34.0mm。所有患者在随访时均出现 0 级或 1 级主动脉瓣反流。

结论

需要长期随访以证明该手术的耐久性。

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