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采用部分布罗姆技术成功手术修复合并二叶式瓣膜及冠状动脉口位置异常的瓣上主动脉狭窄:病例报告

A successful surgical repair for supravalvular aortic stenosis with a bicuspid valve and malpositioned coronary orifices by partial Brom's technique: a case report.

作者信息

Hara Midori, Honda Yoshihiro, Kaga Shigeaki, Sakamoto Kisaburo, Nakajima Hiroyuki

机构信息

Department of Surgery II, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-city, Yamanashi, 409-3898, Japan.

Department of Cardiovascular Surgery, Mt. Fuji Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan.

出版信息

Surg Case Rep. 2024 Oct 24;10(1):242. doi: 10.1186/s40792-024-02039-w.

Abstract

BACKGROUND

Supravalvular aortic stenosis (SVAS) is a relatively rare form of left ventricular outflow tract obstruction, often accompanied by other cardiac conditions. However, a standard surgical reparative technique has not been established and repairing SVAS remains challenging.

CASE PRESENTATION

We repaired SVAS of a 3-year-old boy accompanied by a bicuspid aortic valve and malpositioned coronary orifices by partial Brom's technique with two glutaraldehyde-treated autologous pericardial patches, using recent advanced preoperative information, including geometric and effective heights. Echocardiography after the surgery revealed release of SVAS without aortic regurgitation.

CONCLUSIONS

In repair for SVAS, it is important not only to release stenosis but also to make a functional aortic valve, using recent advanced preoperative information. In the case of children, repairing the aortic valve by only using autologous tissue having growth potential, is also important.

摘要

背景

主动脉瓣上狭窄(SVAS)是一种相对罕见的左心室流出道梗阻形式,常伴有其他心脏疾病。然而,尚未建立标准的手术修复技术,修复SVAS仍然具有挑战性。

病例介绍

我们采用部分布罗姆技术,使用两片经戊二醛处理的自体心包补片,利用包括几何高度和有效高度等最新的术前先进信息,为一名3岁伴有二叶式主动脉瓣和冠状动脉口位置异常的男孩修复了SVAS。术后超声心动图显示SVAS解除且无主动脉瓣反流。

结论

在修复SVAS时,利用最新的术前先进信息不仅要解除狭窄,还要制作一个功能性主动脉瓣,这很重要。对于儿童病例,仅使用具有生长潜力的自体组织修复主动脉瓣也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9c8/11499491/a6273662a10b/40792_2024_2039_Fig1_HTML.jpg

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