Shin H, Farnsworth A, Spratt P
Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, Australia.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):101-4.
Homograft aortic root replacement was done to three patients and the anterior mitral leaflet of the homograft was used with success in all cases. Case 1. A 37-year-old man had late-onset active prosthetic valve endocarditis with a fistula from the aortic annulus to the left atrium. The fistula was closed by using a homograft anterior mitral leaflet and the aortic root was replaced by a homograft with reimplantation of the coronary arteries. He is very well without evidence of recurrent endocarditis 29 months after the operation. Case 2. A 37-year-old man had early-onset active prosthetic valve endocarditis and developed the same fistula as case 1. He was treated successfully as in case 1. He is very well 4 months after the operation. Case 3. A 50-year-old woman, who had undergone aortic commissurotomy due to aortic valvular stenosis fifteen years before, deteriorated again. She had subvalvular membranous stenosis and a small aortic annulus. Konno-Soma procedure was applied to enlarge the annulus and the aortic root was replaced by a homograft. The interventricular septal incision was closed successfully with use of the anterior mitral leaflet of the homograft. Homograft aortic root replacement was an attractive procedure for prosthetic valve endocarditis or a small aortic annulus, and the homograft anterior mitral leaflet was useful for closing the fistula due to the infection and for closing the interventricular septal incision of Konno-Soma procedure.
对三名患者进行了同种异体主动脉根部置换术，同种异体瓣膜的前叶二尖瓣在所有病例中均成功使用。病例1.一名37岁男性患有迟发性人工瓣膜心内膜炎，伴有从主动脉瓣环至左心房的瘘管。通过使用同种异体二尖瓣前叶封闭瘘管，并使用同种异体移植物置换主动脉根部，同时重新植入冠状动脉。术后29个月，他情况良好，无复发性心内膜炎迹象。病例2.一名37岁男性患有早发性人工瓣膜心内膜炎，并出现了与病例1相同的瘘管。他接受了与病例1相同的成功治疗。术后4个月，他情况良好。病例3.一名50岁女性，15年前因主动脉瓣狭窄接受了主动脉瓣交界切开术，病情再次恶化。她存在瓣下膜性狭窄和小主动脉瓣环。应用Konno-Soma手术扩大瓣环，并使用同种异体移植物置换主动脉根部。使用同种异体二尖瓣前叶成功闭合了室间隔切口。同种异体主动脉根部置换术对于人工瓣膜心内膜炎或小主动脉瓣环是一种有吸引力的手术方法，同种异体二尖瓣前叶可用于闭合因感染导致的瘘管以及闭合Konno-Soma手术的室间隔切口。
