Motohashi Yoshikazu, Katsumata Takahiro, Suzuki Tatsuya, Shimada Ryo, Konishi Hayato, Fukuhara Shinji, Kanki Sachiko, Daimon Masahiro, Ozawa Hideki, Nemoto Shintaro
Department of Cardiovascular Surgery, Osaka Medical College, Takatsuki, Japan.
Kyobu Geka. 2017 Sep;70(10):811-815.
Quadricuspid aortic valve is a rare congenital disease. We experienced 3 surgical cases of quadricuspid aortic valve. Patient 1 was a 72-year-old man who was noted to have a quadricuspid aortic valve associated with aortic regurgitation and an ascending aortic aneurysm(51 mm in diameter). He underwent replacement of the aortic valve and the ascending aorta. Patient 2 was a 71-year-old man with severe aortic stenosis, regurgitation, and coronary triple vessel disease. He underwent aortic valve replacement and coronary artery bypass grafting. Preoperative echocardiography revealed no abnormalities in the number of valve leaflets, but quadricuspid aortic valve was identified during surgery. Patient 3 was a 79-year-old man with severe aortic regurgitation, who underwent aortic valve replacement. In all patients, the 4 valve cusps were approximately of the same size. Multi-detector computed tomography is useful for evaluation of valve morphology. Indication of prophylactic ascending aorta replacement in patients with aortic dilatation requires further study.
四叶式主动脉瓣是一种罕见的先天性疾病。我们经历了3例四叶式主动脉瓣手术病例。病例1是一名72岁男性,被发现患有四叶式主动脉瓣并伴有主动脉瓣反流和升主动脉瘤(直径51毫米)。他接受了主动脉瓣置换和升主动脉置换手术。病例2是一名71岁男性,患有严重的主动脉瓣狭窄、反流和冠状动脉三支血管病变。他接受了主动脉瓣置换和冠状动脉搭桥手术。术前超声心动图未发现瓣膜小叶数量异常,但手术中发现为四叶式主动脉瓣。病例3是一名79岁男性,患有严重的主动脉瓣反流,接受了主动脉瓣置换手术。在所有患者中,4个瓣膜尖大小大致相同。多排螺旋计算机断层扫描对评估瓣膜形态很有用。对于主动脉扩张患者预防性升主动脉置换的指征需要进一步研究。