Yoshikai M, Sakuragi T, Doi K, Nakayama Y, Natsuaki M, Itoh T
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
Kyobu Geka. 1995 May;48(5):385-7.
A case of 31-year-old man with ruptured aneurysm of the sinus Valsalva into right atrium originating from noncoronary sinus (Konno's classification type IV) was presented. Patch closure of the defect was carried out through aortotomy followed by resection and direct closure of the aneurysm from right atrium. When placing the patch, pledgetted mattress sutures were passed to the aortic annulus from left ventricle to aorta. It could avoid distortion of aortic valve cusp. Attempting surgical treatment for this type of aneurysm, repair of the defect should be performed through aortotomy to ensure the repair and avoid recurrence of aneurysm, injury to aortic valve and conduction system. Repair from aorta is mandatory, and it is also necessary to open right atrium for the exact inspection of tricuspid valve.
本文报告一例31岁男性患者，其瓦尔萨尔瓦窦瘤破裂进入右心房，起源于无冠窦（Konno分类IV型）。通过主动脉切开术对缺损进行补片修补，随后从右心房切除并直接闭合动脉瘤。放置补片时，带垫片的褥式缝线从左心室穿过至主动脉瓣环再到主动脉。这样可避免主动脉瓣叶变形。对于此类动脉瘤尝试进行手术治疗时，应通过主动脉切开术修复缺损，以确保修复效果并避免动脉瘤复发、主动脉瓣损伤及传导系统损伤。必须从主动脉进行修复，同时也有必要打开右心房以准确检查三尖瓣。
