Sugawara E, Yokota Y, Okamoto F, Kiyota Y, Nakayama S, Matsuno S, Ikeda T
Department of Cardiovascular Surgery, Hyogo Kenritsu Amagasaki Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1988 Oct;89(10):1699-706.
Twelve patients with complete transposition of the great arteries who had arterial switch operation were investigated by postoperative cineangiogram to assess the size and configuration of the functional aortic root. Three patients underwent Damus-Kaye-Stansel operation and the remaining nine received Lecompte modification of Jatene operation. Aortogram showed trivial or mild aortic regurgitation in six patients who underwent Jatene operation but no regurgitation was detected in patients after Damus-Kaye-Stansel operation, arterial switch operation without coronary relocation. The patients were divided into two groups according to the aortographic findings: AR(-); patients with competent aortic valve, AR(+); patients with incompetent aortic valve. Comparison was made between these two groups, measuring new aortic root diameter at three levels. The systolic diameter of distal aortic root was significantly enlarged in AR(+) group as compared to AR(-) group. These results suggest that the relocation of the coronary arteries and the dilatation of aortic root may contribute to aortic regurgitation after Jatene operation.
对12例行大动脉调转术的完全性大动脉转位患者进行术后心血管造影检查,以评估功能性主动脉根部的大小和形态。3例患者接受了达姆斯-凯-斯坦塞尔手术,其余9例接受了贾滕手术的勒孔特改良术。主动脉造影显示,接受贾滕手术的6例患者有轻微或轻度主动脉瓣反流,但在接受达姆斯-凯-斯坦塞尔手术(未进行冠状动脉重新定位的大动脉调转术)的患者中未检测到反流。根据主动脉造影结果将患者分为两组:AR(-)组,主动脉瓣功能正常的患者;AR(+)组,主动脉瓣功能不全的患者。对这两组患者进行比较,在三个水平测量新的主动脉根部直径。与AR(-)组相比,AR(+)组主动脉根部远端的收缩期直径明显增大。这些结果表明,冠状动脉重新定位和主动脉根部扩张可能导致贾滕手术后主动脉瓣反流。