Yang Yuehang, Liu Xinyi, Liu Junwei, Shi Jiawei, Li Huadong
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2024 Dec 11;11:1471686. doi: 10.3389/fcvm.2024.1471686. eCollection 2024.
Bicuspid aortic valve (BAV), the most common congenital cardiac anomaly, predisposes individuals to aortic stenosis and regurgitation due to valve degeneration. Abnormal hemodynamics, arterial wall characteristics, and genetic factors contribute to ascending aorta dilatation, potentially leading to severe complications like aortic dissection. Presently, the most recent guidelines propose that individuals with BAV requiring valve replacement due to valve dysfunction should undergo simultaneous replacement of the ascending aorta when the diameter of aortic dilatation exceeds 4.5 cm. A 60-year-old female patient previously underwent mechanical aortic valve replacement and ascending aortoplasty at our center due to aortic stenosis and a 4.3 cm diameter ascending aorta. In the sixth postoperative year, she was readmitted due to ascending aorta rupture, resulting in blood entering the right atrium and causing acute right heart failure. We performed repair of the rupture and concomitant ascending aorta replacement to prevent further exacerbation of the patient's condition.
二叶式主动脉瓣（BAV）是最常见的先天性心脏异常，由于瓣膜退变，患者易患主动脉狭窄和反流。异常的血流动力学、动脉壁特征和遗传因素导致升主动脉扩张，可能引发诸如主动脉夹层等严重并发症。目前，最新指南建议，因瓣膜功能障碍需要进行瓣膜置换的BAV患者，当主动脉扩张直径超过4.5 cm时，应同时进行升主动脉置换。一名60岁女性患者此前因主动脉狭窄和直径4.3 cm的升主动脉在我们中心接受了机械主动脉瓣置换和升主动脉成形术。术后第六年，她因升主动脉破裂再次入院，血液进入右心房，导致急性右心衰竭。我们对破裂处进行了修复，并同时进行了升主动脉置换，以防止患者病情进一步恶化。
