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一名年轻患者的主动脉单叶瓣手术:病例报告

Aortic Unicuspid Valve Surgery in a Young Patient: A Case Report.

作者信息

Nakajima Tomohiro, Shibata Tsuyoshi, Iba Yutaka, Akatsuka Masayuki, Kawaharada Nobuyoshi

机构信息

Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.

Department of Intensive Care Medicine, Sapporo Medical University, Sapporo, JPN.

出版信息

Cureus. 2024 Dec 8;16(12):e75305. doi: 10.7759/cureus.75305. eCollection 2024 Dec.

Abstract

The patient was a 33-year-old male. He was noted to have a systolic murmur in the aortic valve region during childhood and underwent balloon valvuloplasty at a pediatric clinic. However, he was not followed up thereafter. Recently, he began experiencing exertional dyspnea and presented to our cardiology department. Detailed examinations, including echocardiography, revealed moderate aortic regurgitation and stenosis, and a unicuspid aortic valve was suspected morphologically. After discussing the findings with the patient, he opted for surgical treatment. The operation was performed under general anesthesia via a median sternotomy. Intraoperative inspection of the aortic valve confirmed a unicuspid morphology, consistent with the preoperative findings. The unicuspid valve was excised and replaced with a mechanical valve (St. Jude Medical (SJM) 25 mm). The surgery was completed without complications, and the postoperative course was uneventful. The patient was discharged home on postoperative day 10. Five years postoperatively, the patient remains asymptomatic and in good condition. Given the rarity of unicuspid aortic valve cases, this report is of significant clinical value.

摘要

该患者为一名33岁男性。他在儿童时期被发现主动脉瓣区有收缩期杂音,并在一家儿科诊所接受了球囊瓣膜成形术。然而,此后他未接受随访。最近,他开始出现劳力性呼吸困难,并到我们的心脏病科就诊。包括超声心动图在内的详细检查显示有中度主动脉瓣反流和狭窄,形态学上怀疑为单叶主动脉瓣。与患者讨论检查结果后,他选择了手术治疗。手术在全身麻醉下通过正中胸骨切开术进行。术中对主动脉瓣的检查证实为单叶形态,与术前检查结果一致。切除单叶瓣膜并置换为机械瓣膜(圣犹达医疗公司(SJM)25毫米)。手术顺利完成,无并发症,术后病程平稳。患者于术后第10天出院回家。术后五年,患者仍无症状,状况良好。鉴于单叶主动脉瓣病例罕见,本报告具有重要的临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ea/11704650/42e16285f5c7/cureus-0016-00000075305-i01.jpg

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