Murase Toshifumi, Tamura Susumu, Ohzeki Yasuhiro, Ebine Kunio
Department of Cardiovascular Surgery, Odawara Cardiovascular Hospital, Odawara, Japan.
Kyobu Geka. 2017 Sep;70(10):851-854.
The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve. An aneurysm originating from the anterior sinus of Valsalva had ruptured into the right ventricular outflow tract. The ruptured aneurysm and VSD were repaired by patch closure through the right ventricular outflow tract. Additionally, the aneurysm of the sinus of Valsalva was repaired with direct closure through aortotomy. The insufficient bicuspid aortic valve was replaced with a bioprosthetic valve. After the operation, heart failure improved promptly, and he was making satisfactory progress in his recovery.
在老年人中，瓦尔萨尔瓦窦瘤破裂与二叶式主动脉瓣并存的情况非常罕见。一名患有瓦尔萨尔瓦窦瘤破裂和二叶式主动脉瓣的71岁男性接受了手术。他因心力衰竭入住另一家医院。后转至我院接受瓦尔萨尔瓦窦瘤破裂的治疗。在我院，超声心动图检查结果显示瓦尔萨尔瓦窦瘤破裂、室间隔缺损（VSD）以及严重主动脉瓣反流合并二叶式主动脉瓣中度狭窄。一个源自瓦尔萨尔瓦前窦的瘤体已破裂进入右心室流出道。通过右心室流出道的补片修补术修复了破裂的瘤体和室间隔缺损。此外，通过主动脉切开术直接缝合修复了瓦尔萨尔瓦窦瘤。用生物瓣替换了功能不全的二叶式主动脉瓣。术后，心力衰竭迅速改善，他在恢复过程中进展良好。
