Aoyagi S, Kosuga K, Tanaka K, Ando F, Hara H, Oishi K
Second Department of Surgery, Kurume University School of Medicine.
Kyobu Geka. 1990 May;43(5):404-7.
Five surgically treated cases of supravalvular aortic stenosis were reported. Preoperative cardiac catheterization revealed marked left ventricular-aortic pressure gradient ranged from 20 to 180 mmHg (median, 80.2 mmHg) and retrograde aortogram showed localized (hourglass type) supravalvular aortic stenosis in all cases. A traditional diamond shaped patch aortoplasty was used to relieve supravalvular aortic stenosis in 1 case and an extended aortoplasty was used in last 4 cases. Pressure gradients were almost disappeared postoperatively with good surgical result. The extended aortoplasty is considered to be more reasonable than the traditional aortoplasty in relieving constriction symmetrically and restoring normal relationship of the aortic valve cusps and coronary ostia. The operative indication and selection of the operative procedures for supravalvular aortic stenosis were briefly discussed.
报告了5例经手术治疗的瓣上主动脉狭窄病例。术前心导管检查显示左心室-主动脉压力阶差明显，范围为20至180 mmHg（中位数为80.2 mmHg），逆行主动脉造影显示所有病例均为局限性（沙漏型）瓣上主动脉狭窄。1例采用传统菱形补片主动脉成形术缓解瓣上主动脉狭窄，后4例采用扩大主动脉成形术。术后压力阶差几乎消失，手术效果良好。在对称缓解狭窄以及恢复主动脉瓣叶和冠状动脉开口的正常关系方面，扩大主动脉成形术被认为比传统主动脉成形术更合理。简要讨论了瓣上主动脉狭窄的手术指征和手术方法的选择。
