Katayama Y, Takao M, Onoda K, Shinpo H, Mizutani T, Yada K, Yuasa H, Kusagawa M
Department of Thoracic Surgery, Mie University School of Medicine.
Kyobu Geka. 1990 May;43(5):378-82.
Twenty-four patients with aneurysm of Valsalva sinus were surgically repaired over a 23 year period (1965-1988). These patients were ranged 2 to 54 years of age and eleven of them were male. Rupture of aneurysm of Valsalva sinus was combined with aneurysm in 20 cases, ventricular septal defect in 12 cases and aortic regurgitation in 6 cases. At present, our routine operative procedure for ruptured aneurysm is direct closure of the defect with patch closure of aneurysm after resection of the aneurysm, but when the diameter of aneurysm is smaller than 7 mm, direct closure of the defect of the aneurysm was used. Only one patient after patch closure of ruptured sinus of Valsalva (Konno type I) required reoperation for penetration into left ventricle. This case might be avoided if patch was sutured to annulus of aortic valve. There were two operative death and one late death. The former died of cerebral infarction and low output syndrome, the latter died of sepsis. The mean follow-up period (+/- standard deviation) was 8.2 +/- 6.0 years. All patients that were followed were thirteen and found to be in New York Heart Association class I.
在1965年至1988年的23年期间，对24例瓦氏窦瘤患者进行了手术修复。这些患者年龄在2岁至54岁之间，其中11例为男性。20例瓦氏窦瘤破裂合并有动脉瘤，12例合并室间隔缺损，6例合并主动脉瓣反流。目前，我们对破裂动脉瘤的常规手术方法是在切除动脉瘤后用补片修补动脉瘤缺损直接关闭，但当动脉瘤直径小于7mm时，则采用直接关闭动脉瘤缺损的方法。只有1例瓦氏窦破裂（康诺I型）补片修补术后患者因穿透左心室需要再次手术。如果将补片缝合到主动脉瓣环上，这种情况可能会避免。有2例手术死亡和1例晚期死亡。前者死于脑梗死和低心排血量综合征，后者死于败血症。平均随访期（±标准差）为8.2±6.0年。接受随访的所有患者共13例，均处于纽约心脏协会I级。
