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冠状动脉开口预置补片在 Bentall 手术中的应用。

Application of preset coronary artery orifice patch in Bentall surgery.

机构信息

Department of Cardiovascular Surgery, Second Afliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.

出版信息

J Cardiothorac Surg. 2024 Sep 11;19(1):525. doi: 10.1186/s13019-024-03029-7.

Abstract

BACKGROUND

Bentall surgery is the main method for treating aortic root lesions, but traditional Bentall method is very difficult for patients with mild aortic sinus dilation to directly anastomose the coronary artery orifice with graft.

CASE PRESENTATION

A 41-year-old man was admitted to hospital after severe chest pain. Computed tomography angiography(CTA)revealed a type A aortic dissection. Echocardiography showed moderate aortic valve regurgitation and an aortic sinus diameter of 38 mm( mm). The patient underwent emergency Bentall surgery (using a preset coronary artery orifice patch), total arch replacement, and implantation of a graft into the descending aorta. Follow-up echocardiography showed the patient cardiac function was good, and there was no residual leakage at the coronary artery orifice.

CONCLUSIONS

This method is an alternative to traditional Bentall surgery and is suitable for all aortic root lesions, especially those with mild aortic sinus dilation or concomitant aortic dissection.

摘要

背景

Bentall 手术是治疗主动脉根部病变的主要方法,但传统的 Bentall 方法对于主动脉窦轻度扩张的患者直接用移植物吻合冠状动脉开口非常困难。

病例介绍

一名 41 岁男性因严重胸痛入院。计算机断层扫描血管造影(CTA)显示 A 型主动脉夹层。超声心动图显示中度主动脉瓣反流和主动脉窦直径 38mm(mm)。患者接受了紧急 Bentall 手术(使用预设的冠状动脉开口补片)、全弓置换和降主动脉内植入移植物。随访超声心动图显示患者心功能良好,冠状动脉开口无残余漏。

结论

该方法是传统 Bentall 手术的一种替代方法,适用于所有主动脉根部病变,特别是那些主动脉窦轻度扩张或合并主动脉夹层的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d25/11389235/64ee9a17bf39/13019_2024_3029_Fig1_HTML.jpg

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