Woś S, Matuszewski M, Bachowski R, Ceglarek W, Jasiński M, Domaradzki W, Toczek K, Korzeniowska B, Iwiński J
II Department of Cardiac Surgery, Silesian Medical Academy, Katowice, Poland.
J Cardiovasc Surg (Torino). 1994 Dec;35(6 Suppl 1):219-22.
Five patients were operated on because of ruptured aneurysm of the sinus of Valsalva. In the cases with no concomitant VSD the surgical access from the aorta was used. The aorta was opened and the Fogarty catheter was introduced to the fistula. The "wind sock" of the aneurysm was pulled back to the aorta and excised. The opening was closed with double-line pledgetted polypropylene sutures. In severe aortic incompetence mechanical prostheses were implanted. One patient had bacterial endocarditis with reopening of the fistula and aortic valve incompetence that required reoperation. All patients are in a good clinical state. We recommend the use of Dacron patches even in small aneurysms to avoid re-opening of the fistula.
5例患者因瓦氏窦瘤破裂接受手术。在无合并室间隔缺损的病例中，采用经主动脉的手术入路。打开主动脉，将Fogarty导管插入瘘口。将动脉瘤的“风袋”拉回主动脉并切除。用带垫片的双线聚丙烯缝线关闭开口。对于严重主动脉瓣关闭不全患者，植入机械瓣膜。1例患者发生细菌性心内膜炎，瘘口重新开放且主动脉瓣关闭不全，需要再次手术。所有患者临床状态良好。我们建议即使是小动脉瘤也使用涤纶补片，以避免瘘口重新开放。
