Kawahira Y, Kishimoto H, Iio M, Ikawa S, Ueda H, Maeno T, Kayatani F, Inamura N, Nakada T
Department of Cardiovascular Surgery, Osaka Medical Center, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1003-6.
Surgical treatment for a hypoplastic aortic arch associated with coarctation or interruption of the aorta is controversial. We evaluate the changes of diameter of proximal transverse aortic arch after surgery in 28 patients. Proximal transverse aortic arch in all patients was preoperatively 3.5 +/- 0.9 mm (2.5 to 7 mm), and 54 +/- 12% (36 to 84%) to the normal aortic valve dimension (n-AVD: 16.6 X BSA0.6). While postoperative proximal transverse aortic arch was 6.5 +/- 1.8 mm, and 76 +/- 12% to the n-AVD, and significantly grew more than the preoperative arch dimension (p = 0.0001). In 18 patients having two times cardiac catheterization postoperatively, proximal transverse aortic arch was 6.5 +/- 1.6 mm, and 75 +/- 13% to n-AVD on the 1st postoperative examination. On the 2nd examination, the arch was 9.9 +/- 1.9 mm, and 88 +/- 12% to n-AVD, and significantly grew with increasing years (p < or = 0.0003). We concluded that the proximal transverse aortic arch, which was more than 36% to n-AVD in diameter, if not dilated surgically, grew with increasing years after aortic arch repair.
对于合并主动脉缩窄或中断的发育不全主动脉弓，手术治疗存在争议。我们评估了28例患者术后近端横主动脉弓直径的变化。所有患者术前近端横主动脉弓直径为3.5±0.9mm（2.5至7mm），为正常主动脉瓣尺寸（n-AVD：16.6×体表面积0.6）的54±12%（36%至84%）。术后近端横主动脉弓直径为6.5±1.8mm，为n-AVD的76±12%，明显大于术前弓部尺寸（p = 0.0001）。18例术后接受两次心导管检查的患者，术后第一次检查时近端横主动脉弓直径为6.5±1.6mm，为n-AVD的75±13%。第二次检查时，弓部直径为9.9±1.9mm，为n-AVD的88±12%，且随时间显著增大（p≤0.0003）。我们得出结论，直径大于n-AVD 36%的近端横主动脉弓，若未进行手术扩张，在主动脉弓修复术后会随时间增长。
