Mullen J C, Baird R J, Komeda M
Department of Surgery, University of Alberta, Edmonton.
Can J Cardiol. 1994 Jan-Feb;10(1):59-62.
The standard treatment of ascending aortic aneurysms (AsAAs) with annulo-aortic ectasia and aortic insufficiency has been composite graft replacement of the valve and ascending aorta. The authors propose a method of repair which preserves the native aortic valve and correct the aneurysmal dilation of the sinus of Valsalva yet preserves its normal shape.
PATIENTS/INTERVENTIONS: Two patients with large AsAAs and severe aortic insufficiency had operative repair by plication of the sinuses of Valsalva which maintained the normal sinus shape and restored coaptation of the aortic leaflets.
Late postoperative echocardiography revealed only mild aortic insufficiency in both patients and no evidence of further sinus dilation.
Repair of the sinus of Valsalva preserves the aortic valve and native coronary ostia, can correct existing aortic insufficiency and can provide a good functional result without the need for anticoagulation.
对于伴有瓣环主动脉扩张和主动脉瓣关闭不全的升主动脉瘤（AsAAs），标准治疗方法是进行瓣膜和升主动脉的复合移植置换术。作者提出一种修复方法，该方法保留天然主动脉瓣，纠正主动脉瓣窦瘤样扩张，同时保持其正常形态。
患者/干预措施：两名患有大型AsAAs和严重主动脉瓣关闭不全的患者接受了手术修复，通过折叠主动脉瓣窦来维持正常的窦形态，并恢复主动脉瓣叶的对合。
术后晚期超声心动图显示，两名患者均仅有轻度主动脉瓣关闭不全，且无进一步窦扩张的迹象。
主动脉瓣窦修复术保留了主动脉瓣和天然冠状动脉开口，可纠正现有的主动脉瓣关闭不全，并且无需抗凝即可提供良好的功能结果。
