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[伴有主动脉瓣反流及右冠状动脉开口狭窄的右冠窦外非破裂性动脉瘤;病例报告]

[Extra cardiac unruptured aneurysm of the right sinus of Valsalva with aortic regurgitation and right coronary ostial stenosis; report of a case].

作者信息

Kazuno Kei, Nakanishi Sentarou, Ohtani Norifumi

机构信息

Department of Cardiovascular Surgery, Steel Memorial Muroran Hospital, Muroran, Japan.

出版信息

Kyobu Geka. 2013 Mar;66(3):237-40.

Abstract

A 78-year-old female presented with a chief complaint of palpitations. She was diagnosed with a large unruptured aneurysm of the sinus of Valsalva accompanying aortic regurgitation and right coronary artery ostial stenosis. When the aneurysm was resected following cardiac arrest, it was found to be an aneurysm with the right Valsalva sinus at the orifice. Root replacement was not required because there was no aortic annular dilatation. Patch closure as well as aortic valve replacement were conducted. The right coronary artery was diverged from the aneurysm and the aperture thereof was severely stenosed. Therefore, bypass surgery was additionally conducted. Postoperative course was uneventful. An unruptured aneurysm of the sinus of Valsalva, which is a relatively rare disease, is asymptomatic in many cases and tends to have grown large when found. Because the postoperative results were relatively good, we believe that surgery should be performed at an early stage in order to avoid rupture.

摘要

一名78岁女性因心悸为主诉前来就诊。她被诊断为伴有主动脉瓣反流和右冠状动脉开口狭窄的巨大未破裂瓦氏窦瘤。在心脏骤停后切除该瘤时,发现其为起源于右瓦氏窦口的瘤。由于无主动脉环扩张,无需进行根部置换。进行了补片修补以及主动脉瓣置换。右冠状动脉从瘤体发出且其开口严重狭窄。因此,额外进行了搭桥手术。术后病程顺利。瓦氏窦未破裂瘤是一种相对罕见的疾病,很多情况下无症状,发现时往往已长得很大。由于术后结果相对良好,我们认为应尽早进行手术以避免破裂。

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