Department of Cardiovascular Surgery, Nagasaki University Hospital, Nagasaki, Japan.
Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1196-1198. doi: 10.1093/ejcts/ezz140.
We report the case of a 15-year-old male patient who had developed aortic regurgitation primarily because of aortic annulus dilatation late after definitive repair of tetralogy of Fallot. Valsalva sinus dilatation was not remarkable enough for root replacement. For the purpose of total root remodelling, the Sleeve procedure was employed. This procedure not only reduced the root diameters but also augmented commissure heights. With concomitant non-coronary cusp plication, aortic regurgitation was effectively controlled. Thus, the Sleeve technique may be a preferable option for patients who develop aortic regurgitation, due to dilatation of the annulus or sinotubular junction without significant dilatation of the sinus of Valsalva, after congenital heart surgery.
我们报告了一例 15 岁男性患者，他因法洛四联症根治术后晚期主动脉瓣环扩张而主要出现主动脉瓣反流。由于窦部扩张不够明显，不适合行根部置换术。为了进行完全的根部重塑，我们采用了 Sleeve 手术。该手术不仅减小了根部直径，还增加了瓣叶交界高度。同时行非冠状动脉瓣叶折叠术，有效地控制了主动脉瓣反流。因此，对于先天性心脏病手术后由于瓣环或窦管交界扩张而无明显窦部扩张导致出现主动脉瓣反流的患者，Sleeve 技术可能是一种更好的选择。
