Furuta Akihisa, Morimoto Hironobu, Mukai Shogo, Futagami Daisuke, Okubo Shuhei
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
J Card Surg. 2019 Oct;34(10):1133-1136. doi: 10.1111/jocs.14203. Epub 2019 Aug 2.
To reveal a technical feasibility and safety of valve-sparing partial aortic root repair for spontaneous aortic dissection limited to the right coronary sinus of Valsalva.
A 68-year-old woman presented with chest pain. Twelve-lead electrocardiogram revealed atrioventricular dissociation and ST-segment elevation on II, III, and aVF. Enhanced computed tomography images showed aortic dissection limited to the right-coronary sinus and the other non-dilated sinuses of Valsalva. Localized aortic dissection was repaired by valve-sparing partial aortic root repair using a trimmed U-shaped Dacron graft and a felt strip, and the right coronary artery was revascularized by coronary artery bypass grafting using saphenous vein graft.
The patient was discharged on postoperative day 12 with no complications.
Valve-sparing partial aortic root repair with the patch and coronary artery bypass grafting for aortic dissection limited to the right coronary sinus of Valsalva were technically feasible and safe.
揭示针对局限于瓦尔萨尔瓦右冠状动脉窦的自发性主动脉夹层进行保留瓣膜的部分主动脉根部修复术的技术可行性与安全性。
一名68岁女性因胸痛就诊。12导联心电图显示房室分离，Ⅱ、Ⅲ及aVF导联ST段抬高。增强CT图像显示主动脉夹层局限于右冠状动脉窦及其他未扩张的瓦尔萨尔瓦窦。采用修剪后的U形涤纶补片和毡条行保留瓣膜的部分主动脉根部修复术修复局限性主动脉夹层，并用大隐静脉移植行冠状动脉旁路移植术使右冠状动脉血运重建。
患者术后第12天出院，无并发症。
对于局限于瓦尔萨尔瓦右冠状动脉窦的主动脉夹层，采用补片和冠状动脉旁路移植术进行保留瓣膜的部分主动脉根部修复术在技术上是可行且安全的。
