Kent William D T, Toeg Hadi D, Appoo Jehangir J
Division of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta T2N 2T9, Canada.
Tex Heart Inst J. 2014 Feb;41(1):67-9. doi: 10.14503/THIJ-12-3049.
Aortic valve repair can be a good option in younger patients who have severe aortic regurgitation. A systematic, disease-directed approach can simplify repair. This case report describes how a simplified approach can be successfully applied to complex pathologic conditions of the aortic valve. A 49-year-old man with a bicuspid aortic valve and a history of endocarditis presented with severe aortic regurgitation and evidence of recurrent infection. Intraoperatively, we found congenital and degenerative aortic anatomy with endocarditis and perforation. We performed aortic valve repair to enable leaflet coaptation and to adjust the coaptation height. After 24 months, the patient remained well, with an intact repair and trivial aortic regurgitation. We describe our systematic repair approach and rationales for targeting repairs to identified lesions. To our knowledge, this is the first description of complex aortic valve repairs in a patient who had simultaneous congenital, degenerative, and infectious conditions.
对于患有严重主动脉瓣反流的年轻患者，主动脉瓣修复可能是一个不错的选择。一种系统的、针对疾病的方法可以简化修复过程。本病例报告描述了一种简化方法如何成功应用于主动脉瓣的复杂病理状况。一名49岁的男性，患有二叶式主动脉瓣且有感染性心内膜炎病史，出现严重主动脉瓣反流并有反复感染的迹象。术中，我们发现了伴有感染性心内膜炎和穿孔的先天性及退行性主动脉解剖结构。我们进行了主动脉瓣修复，以使瓣叶能够贴合，并调整贴合高度。24个月后，患者情况良好，修复完好，仅有微量主动脉瓣反流。我们描述了我们的系统修复方法以及针对已识别病变进行修复的原理。据我们所知，这是首次对一名同时患有先天性、退行性和感染性疾病的患者进行复杂主动脉瓣修复的描述。
