Kırali Kaan
Department of Cardiovascular Surgery, Koşuyolu Heart and Research Hospital, Istanbul, Turkey
Asian Cardiovasc Thorac Ann. 2016 Jun;24(5):467-9. doi: 10.1177/0218492315575847. Epub 2015 Mar 9.
The presence of patent vein grafts on the proximal aorta may cause technical difficulties during reoperations for aortic valve replacement after previous coronary artery bypass surgery. A 65-year-old man underwent reoperation for aortic valve replacement two years after his first open heart surgery (valve-sparing aortic root replacement and aorta-right coronary artery saphenous vein graft). The aortotomy incision was started approximately 2 cm above the proximal anastomosis and continued down at both sides until the prosthetic graft. The reverse U aortotomy prevents unnecessary and risky manipulations of proximal anastomoses, provides perfect exposure, and can be used securely during reoperative aortic valve surgery.
在先前冠状动脉搭桥手术后进行主动脉瓣置换再次手术时，近端主动脉上存在通畅的静脉移植物可能会导致技术难题。一名65岁男性在首次心脏直视手术（保留瓣膜的主动脉根部置换术和主动脉 - 右冠状动脉大隐静脉移植物）两年后接受了主动脉瓣置换再次手术。主动脉切开术切口始于近端吻合口上方约2厘米处，两侧向下延伸直至人工移植物。反向U形主动脉切开术可避免对近端吻合口进行不必要且有风险的操作，提供完美的视野，并且在再次进行主动脉瓣手术时可安全使用。
