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[主动脉根部瘤合并感染性心内膜炎的外科治疗]

[Surgical treatment of aortic root aneurysm associating with infectious endocarditis].

作者信息

Kawada T, Koyama T, Nakamura S, Hinata S, Kamata S, Andou N, Mieda T, Okada T, Yamate N

机构信息

Third Department of Surgery, St. Marianna University Hospital.

出版信息

Kyobu Geka. 1990 Oct;43(11):895-9.

PMID:2250436
Abstract

From 1979 to 1989, aortic root aneurysms were encountered in 6 of the 30 patients who underwent surgical treatment for infectious endocarditis. Four patients underwent aortic valve replacement and direct or patch closure of the orifice of aortic root aneurysm. In additional 2 patients with infected aneurysm of right coronary sinus of Valsalva rupturing into the right ventricle, the aneurysm and infected tissue in the right ventricular outflow tract were completely resected and the defect of aortic sinus and VSD were closed with double Teflon fabric patches. All patients survived postoperatively, however, one patients died 1.5 months after the operation probably due to rupture of mycotic aneurysm of cerebral artery. Another late death seemed to be concerned with recurrent aortic root aneurysm, in which case direct closure of aneurysm had been performed. We believe that even if the aneurysm seems to be small, its orifice should be closed with the use of a fabric patch to prevent recurrent aneurysm formation.

摘要

1979年至1989年期间,在30例接受感染性心内膜炎外科治疗的患者中,有6例出现主动脉根部动脉瘤。4例患者接受了主动脉瓣置换术,并直接或用补片封闭主动脉根部动脉瘤的开口。另外2例患者的瓦尔萨尔瓦右冠状动脉窦感染性动脉瘤破裂进入右心室,右心室流出道的动脉瘤和感染组织被完全切除,主动脉窦缺损和室间隔缺损用双层特氟龙织物补片封闭。所有患者术后均存活,然而,1例患者在术后1.5个月死亡,可能是由于霉菌性脑动脉瘤破裂。另一例晚期死亡似乎与复发性主动脉根部动脉瘤有关,在该病例中已对动脉瘤进行了直接封闭。我们认为,即使动脉瘤看起来较小,也应使用织物补片封闭其开口,以防止复发性动脉瘤形成。

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