Okita Yutaka, Takanashi Shuichiro, Fukumura Yoshiaki
Division of Cardiovascular Surgery, Kobe University, Kobe, Japan
Sakakibara Heart Institute, Tokyo, Japan.
Interact Cardiovasc Thorac Surg. 2014 Jul;19(1):166-8. doi: 10.1093/icvts/ivu056. Epub 2014 Mar 30.
Four cases of simultaneous surgery for aortic root aneurysm with aortic regurgitation and coarctation of the aorta were presented. Age at surgery ranged from 18 to 37 years and all were male. All had annuloaortic ectasia and dilatation of the ascending aorta, 3 had bicuspid aortic valve and 1 had acute localized aortic dissection. Preoperative grade of aortic regurgitation was trivial in 1, moderate in 2 and severe in 1. Three had aortic valve-sparing root replacement with reimplantation technique and 1 had plication of the sinotubular junction. All patients had total arch replacement, coarctectomy and orthogonal anastomosis to the descending aorta. Antegrade cerebral perfusion was used for brain protection. All patients survived and postoperative pressure difference between the upper and lower extremities disappeared. Postoperative aortogram was satisfactory.
本文报告了4例同时进行主动脉根部瘤合并主动脉瓣反流及主动脉缩窄手术的病例。手术年龄为18至37岁，均为男性。所有患者均有主动脉瓣环扩张及升主动脉扩张，3例为二叶式主动脉瓣，1例为急性局限性主动脉夹层。术前主动脉瓣反流程度：1例轻微，2例中度，1例重度。3例行保留主动脉瓣的根部置换并采用再植入技术，1例行窦管交界折叠术。所有患者均行全弓置换、主动脉缩窄切除术及与降主动脉的直角吻合。采用顺行性脑灌注进行脑保护。所有患者均存活，术后上下肢压差消失。术后主动脉造影结果满意。
