Papworth Hospital, Cambridge, United Kingdom.
Clinique St. Augustin, Bordeaux, France.
Ann Thorac Surg. 2014 May;97(5):1811-3. doi: 10.1016/j.athoracsur.2013.08.071.
Valve-sparing aortic root replacement (ARR) is the procedure of choice in young patients with aortic root aneurysm and preserved aortic valve leaflets; however, coronary ostial anastomoses remain an issue. Troublesome bleeding sometimes occurs during surgery, and in the long term, there is a risk of aneurysmal formation in the residual aortic wall of the ostial "button." We describe a technique of valve-sparing ARR wherein each coronary button along with its flange of aortic tissue is implanted within the prosthetic graft used for ARR, thereby eliminating the risk of both immediate surgical bleeding and late coronary button aneurysms.
保留主动脉瓣的主动脉根部替换术（ARR）是治疗主动脉根部瘤且主动脉瓣叶保留的年轻患者的首选方法；然而，冠状动脉开口吻合仍然是一个问题。手术过程中有时会发生出血，长期来看，开口“纽扣”处的残留主动脉壁有形成动脉瘤的风险。我们描述了一种保留主动脉瓣的 ARR 技术，其中每个冠状动脉纽扣及其主动脉组织的边缘都被植入用于 ARR 的假体移植物内，从而消除了即刻手术出血和晚期冠状动脉纽扣动脉瘤的双重风险。
