Mizuno A, Kurosawa H, Nakano M, Mashiko K, Sakamoto Y, Shiratori K
Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan.
Kyobu Geka. 1995 Feb;48(2):141-4.
A 53-year-old woman had undergone aortic valve replacement in 1990. Three years later, aortic prosthetic valve endocarditis and aortic root abscess had been noted. Debridement of all apparently infected tissue created left ventricular-aortic discontinuity, but the orifice of the coronary arteries were intact. We decided to reconstruct the left ventricular outflow tract and aortic root by Bentall procedure. Composite graft was made with 26 mm gelseal tube graft and a 23 mm SJM prosthetic valve, and the coronary ostia were sutured into the side of the graft. The patient's recovery was uneventful, and the aortography revealed no aortic regurgitation. We suggest that Bentall procedure using gelseal tube graft is useful to reconstruct the left ventrivular-aortic discontinuity if the coronary ostia were intact.
一名53岁女性于1990年接受了主动脉瓣置换术。三年后,发现人工主动脉瓣心内膜炎和主动脉根部脓肿。清除所有明显感染的组织造成了左心室-主动脉连续性中断,但冠状动脉口完整。我们决定采用Bentall手术重建左心室流出道和主动脉根部。用26mm带垫片的人工血管和23mm的圣犹达医疗公司(SJM)人工瓣膜制作复合移植物,并将冠状动脉口缝合到移植物侧面。患者恢复顺利,主动脉造影显示无主动脉瓣反流。我们认为,如果冠状动脉口完整,使用带垫片人工血管的Bentall手术对于重建左心室-主动脉连续性是有用的。