Sakamoto Kosuke, Totsugawa Toshinori, Hiraoka Arudo, Tamura Kentaro, Yoshitaka Hidenori, Sakaguchi Taichi
Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama.
Int Heart J. 2018 May 30;59(3):634-636. doi: 10.1536/ihj.17-371. Epub 2018 May 9.
An 88-year-old woman was diagnosed with aortic stenosis and an aortic annulus that was too narrow to perform transcatheter aortic valve implantation. Surgery was performed through a 7-cm right mini-thoracotomy at the fourth intercostal space. A 19-mm aortic valve bioprosthesis was implanted after root enlargement. The fourth intercostal space was a suitable site for aortic root enlargement because of the shorter skin-to-root distance and the detailed exposure of the aortic valve after cutting the aortic wall. This study concluded that minimally-invasive aortic valve replacement following root enlargement can be an option for the treatment of elderly patients with aortic stenosis accompanied by an annulus that is too small to perform transcatheter aortic valve implantation.
一名88岁女性被诊断为主动脉瓣狭窄，且主动脉瓣环过窄，无法进行经导管主动脉瓣植入术。通过在第四肋间间隙做一个7厘米的右胸小切口进行手术。在扩大根部后植入了一个19毫米的主动脉瓣生物假体。第四肋间间隙是主动脉根部扩大的合适部位，因为皮肤到根部的距离较短，且切开主动脉壁后主动脉瓣暴露清晰。本研究得出结论，对于伴有瓣环过小而无法进行经导管主动脉瓣植入术的老年主动脉瓣狭窄患者，根部扩大后的微创主动脉瓣置换术可以作为一种治疗选择。
