Seybold-Epting W, Hoffmeister H E
Thorac Cardiovasc Surg. 1980 Dec;28(6):420-2. doi: 10.1055/s-2007-1022443.
Implantation of a small-sized biological prosthesis into a hypoplastic aortic annulus causes significant resting gradients. To make insertion of a suitable biological valve possible, we recommend enlargement of the aortic annulus by extension of the aortic incision into the anterior mitral leaflet for approximately 2 cm. A woven Dacron patch is sutured into the V-shaped defect of the anterior mitral leaflet and the aortic ring. This procedure results in enlargement of the aortic circumference of approximately 20 mm. We have applied this technique in 13 patients with severe aortic valvular disease and a hypoplastic aortic annulus. In all patients a prosthesis with a diameter of at least 25 mm could be implanted. The maximal postoperative pressure gradient measured 18 mmHg. There was no early death related to this operative method. All survivors have excellent clinical results with no evidence of mitral regurgitation. This operation represents a practicable alternative method to left ventricular apico-aortic conduit implantation.
将小型生物假体植入发育不全的主动脉瓣环会导致明显的静息压差。为了能够植入合适的生物瓣膜，我们建议通过将主动脉切口延伸至二尖瓣前叶约2厘米来扩大主动脉瓣环。将编织的涤纶补片缝合到二尖瓣前叶和主动脉环的V形缺损处。此操作可使主动脉周长扩大约20毫米。我们已将此技术应用于13例患有严重主动脉瓣疾病和发育不全主动脉瓣环的患者。所有患者均可植入直径至少为25毫米的假体。术后测得的最大压差为18 mmHg。没有与该手术方法相关的早期死亡病例。所有存活者临床效果良好，无二尖瓣反流迹象。该手术是左心室心尖-主动脉导管植入术的一种可行替代方法。
