Fudulu Daniel, Zakkar Mustafa, Stoica Serban
Department of Cardiac Surgery, Bristol Heart Institute, Bristol, United Kingdom.
Glenfield Hospital, Leicester, United Kingdom.
World J Pediatr Congenit Heart Surg. 2020 Jan;11(1):101-104. doi: 10.1177/2150135119881396.
Reconstruction of the intervalvular fibrosa is normally associated with endocarditis and the surgical principles are well established. Here, we describe how these principles are further extended and applied for the elective enlargement of the aorto-mitral continuity. Our aim was to achieve double valve upsizing in noninfective conditions. The first patient had rheumatic fever and a first double valve replacement as an adult. Her two tissue valves were later upsized at the time of replacement with mechanical prostheses. The concept was then used to perform a substantial annular enlargement in another adult patient whose original double valve replacement was done in childhood, when she received aortic and mitral prostheses measuring 17 and 23 mm, respectively. After upsizing with the technique described, her new valves were 25 and 29 mm in diameter.
瓣间纤维组织重建通常与心内膜炎相关，其手术原则已得到充分确立。在此，我们描述这些原则如何进一步扩展并应用于选择性扩大主动脉 - 二尖瓣连续性。我们的目标是在非感染性情况下实现双瓣膜增大。首例患者患有风湿热，成年时首次进行双瓣膜置换。后来，在更换为机械瓣膜时，她的两个生物瓣膜增大了尺寸。然后，该概念被用于另一名成年患者，该患者童年时进行了初次双瓣膜置换，当时她分别接受了直径为17毫米和23毫米的主动脉瓣和二尖瓣假体。采用所述技术增大尺寸后，她的新瓣膜直径分别为25毫米和29毫米。
