Kawaida Taiki, Tanabe Hiroaki, Kato Yuji, Yamazaki Shintaro, Hosaka Kimio, Toyama Masaaki
Department of Cardiovascular Surgery, Kameda Medical Center, Kamogawa, Chiba, Japan.
SAGE Open Med Case Rep. 2022 Jul 19;10:2050313X221112363. doi: 10.1177/2050313X221112363. eCollection 2022.
We present a case of redo stentless valve operation in a 73-year-old man who underwent aortic valve replacement via the subcoronary approach with a freestyle aortic bioprosthesis 23 years ago at our institution. He was referred for surgery because an echocardiogram showed severe aortic regurgitation due to structural valve deterioration, and aortic valve replacement was planned. Severe circumferential calcification and adhesion were noted during the surgery between the freestyle and native roots. Redo-aortic valve replacement was successful despite the technical difficulty. In stentless valve reoperations following aortic valve replacement via the subcoronary method, the planning of valve-in-valve transcatheter aortic valve implantation and sutureless valve implantation may be a practical and safe strategy.
我们报告一例73岁男性患者的再次无支架瓣膜手术。该患者23年前在我院经冠状动脉下途径使用自由式主动脉生物瓣膜进行了主动脉瓣置换术。因超声心动图显示因瓣膜结构退化导致严重主动脉瓣反流，故转诊接受手术，并计划进行主动脉瓣置换。手术过程中发现自由式瓣膜与天然根部之间存在严重的环状钙化和粘连。尽管技术难度较大，但再次主动脉瓣置换术仍取得成功。在经冠状动脉下方法进行主动脉瓣置换后的无支架瓣膜再次手术中，瓣中瓣经导管主动脉瓣植入术和无缝合瓣膜植入术的规划可能是一种实用且安全的策略。
