Division of Cardiac Surgery, Department of Surgery, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada.
Ann Thorac Surg. 2012 Jan;93(1):290-3. doi: 10.1016/j.athoracsur.2011.08.063.
The technical difficulty of performing the left ventricular apical anastomosis has limited the adoption of aortic valve bypass surgery for the treatment of aortic stenosis. We report the successful use of an automated coring and apical connector device to perform aortic valve bypass surgery.
A 74-year-old man, with a history of prior coronary bypass surgery with patent grafts and a porcelain ascending aorta, presented with symptomatic critical aortic stenosis. Through a left anterolateral thoracotomy, a valved conduit was anastomosed to the descending thoracic aorta. The automated coring and apical connector insertion device was used to core a plug of apical myocardium and simultaneously insert an 18-mm apical connector into the left ventricular apex.
There were no procedural complications, cardiopulmonary bypass was not used, and estimated blood loss was minimal. The patient was discharged on postoperative day 5, and at 3-month follow-up demonstrated significant clinical and hemodynamic improvement.
The automated coring and apical connector insertion device facilitated the safe and effective performance of aortic valve bypass surgery.
由于进行左心室心尖吻合的技术难度限制，主动脉瓣旁路手术在治疗主动脉瓣狭窄方面的应用受到限制。我们报告了成功使用自动化去核和心尖连接装置进行主动脉瓣旁路手术的案例。
一名 74 岁男性，既往有冠状动脉旁路移植术史，移植血管通畅，升主动脉为瓷化主动脉，因有症状的严重主动脉瓣狭窄而就诊。通过左前外侧开胸术，将带瓣管道与降主动脉吻合。使用自动化去核和心尖连接装置在心尖部切除一个心肌塞块，并将一个 18 毫米的心尖连接器同时插入左心室心尖部。
无手术相关并发症，未使用体外循环，估计出血量极少。患者术后第 5 天出院，在 3 个月随访时显示出显著的临床和血液动力学改善。
自动化去核和心尖连接器插入装置有助于安全有效地进行主动脉瓣旁路手术。
