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[瓦氏窦瘤破裂至右心房的外科修复术]

[Surgical repair of ruptured sinus of Valsalva aneurysm to right atrium].

作者信息

Guo Hong-Wei, Chang Qian, Yu Cun-Tao, Sun Xiao-Gang, Qian Xiang-Yang, Wu Yong-Bo, Feng Jun, Hu Sheng-Shou

机构信息

Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2010 Aug 1;48(15):1158-60.

Abstract

OBJECTIVES

To summarize the experience of surgical repair of ruptured sinus of Valsalva aneurysm to right atrium and to compare the difference between through right atrium repair and transaortic combined with right atrium approach.

METHODS

Between January 2004 and December 2009, 53 patients with ruptured sinus of Valsalva aneurysm to right atrium underwent surgical repair. There were 35 male and 18 female, aged from 15 to 63 with a mean of (33 ± 9) years. Repair through right atrium had undergone in 40 patients (group I), while transaortic combined with right atrium approach in 13 patients (group II). Surgical results between the two group and group were compared in cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, ICU time and postoperative stay time.

RESULTS

There were no significant differences between two groups in cardiopulmonary bypass time [(86 ± 29) min vs. (96 ± 30) min], clamp aorta time [(59 ± 29) min vs. (71 ± 25) min], mechanical ventilation time [(9 ± 4) h vs. (16 ± 23) h], ICU time [(35 ± 23) h vs. (35 ± 23) h], postoperative stay time [(7.1 ± 0.9) d vs. (7.7 ± 2.8) d] (P > 0.05). Follow-up was performed from 1 to 64 months, with a mean of (32 ± 21) months. There was no death during follow up. One needed operation due to severe aortic valve regurgitation. One combined with coronary artery disease used medication. Heart function (NYHF) of the other patients were I and II degree during follow up.

CONCLUSIONS

Surgical repair of ruptured sinus of Valsalva aneurysm to right atrium shows good result. There is no significant difference between through right atrium repair and transaortic combined with right atrium approach.

摘要

目的

总结瓦氏窦瘤破裂至右心房的外科修复经验,并比较经右心房修复与经主动脉联合右心房入路的差异。

方法

2004年1月至2009年12月,53例瓦氏窦瘤破裂至右心房患者接受了外科修复。其中男性35例,女性18例,年龄15至63岁,平均(33±9)岁。40例患者采用经右心房修复(I组),13例患者采用经主动脉联合右心房入路(II组)。比较两组患者的体外循环时间、主动脉阻断时间、机械通气时间、重症监护病房(ICU)时间和术后住院时间。

结果

两组患者的体外循环时间[(86±29)分钟对(96±30)分钟]、主动脉阻断时间[(59±29)分钟对(71±25)分钟]、机械通气时间[(9±4)小时对(16±23)小时]、ICU时间[(35±23)小时对(35±23)小时]、术后住院时间[(7.1±0.9)天对(7.7±2.8)天]差异均无统计学意义(P>0.05)。随访1至64个月,平均(32±21)个月。随访期间无死亡病例。1例因严重主动脉瓣反流需要再次手术。1例合并冠心病患者采用药物治疗。其他患者随访期间心功能(纽约心脏协会心功能分级)为I级和II级。

结论

瓦氏窦瘤破裂至右心房的外科修复效果良好。经右心房修复与经主动脉联合右心房入路之间无显著差异。

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