Selle J G, Robicsek F, Daugherty H K, Cook J W, Hess P J
Ann Thorac Surg. 1981 Dec;32(6):578-83. doi: 10.1016/s0003-4975(10)61802-4.
Operative repair of the diseased ascending aorta with aortic valve involvement consists of replacement of the ascending aorta and the aortic valve plus reconstitution of coronary arterial flow. Two basic techniques are presently available. The conventional technique involves separate replacement of the aorta and valve above and below a small segment of retained aorta including the coronary orifices. The second method consists of replacement of the entire ascending aorta and aortic valve with reconstitution of coronary flow by approximation of the coronary orifices to the Dacron conduit or with saphenous vein bypasses. Each method has its merits depending on the exact pathological anatomy encountered near the coronary orifices. Other pathological variables exist that demand additional intraoperative choices in technique. The present report details the operative repair of this lesion and outlines the technical options available for solution of the various problems encountered.
对伴有主动脉瓣受累的病变升主动脉进行手术修复，包括升主动脉和主动脉瓣置换以及冠状动脉血流重建。目前有两种基本技术。传统技术是在一小段保留的包括冠状动脉口的主动脉上方和下方分别置换主动脉和瓣膜。第二种方法是用冠状动脉口靠近涤纶管道或用大隐静脉旁路重建冠状动脉血流，置换整个升主动脉和主动脉瓣。每种方法都有其优点，这取决于在冠状动脉口附近遇到的确切病理解剖结构。还存在其他病理变量，这就需要在术中对技术做出额外选择。本报告详细介绍了该病变的手术修复，并概述了可用于解决所遇到的各种问题的技术选择。
