Taniyasu N, Kou E, Hiramatsu T, Yokoyama S, Takenaka A, Ikawa O
Kyoto 2nd Red Cross Hospital, Japan.
Kyobu Geka. 1997 Feb;50(2):155-7.
The patient was a 48-year-old woman with aortic stenosis and regurgitation and mitral stenosis. Preoperative cardiac catheterization revealed LV-Ao pressure gradient of 30 mmHg and regurgitation of Sellers III. The aortic annulus was measured less than 19 mm. As operative findings, the aortic annulus seemed to be too small to be replaced with 19 mm prosthetic valve. Aortic valvuloplasty (AVP) with rasping technique was performed for the aortic valve and valve replacement was carried out for the mitral valve. After aortic declamping and occurring her beat, the transesophageal echocardiographic evaluation for AVP was effective. Postoperative course was uneventful. Postoperative cardiac catheterization have shown decreased transvalvular pressure gradient up to 10 mmHg and aortic regurgitation of Sellers I.
该患者为一名48岁女性,患有主动脉瓣狭窄和反流以及二尖瓣狭窄。术前心脏导管检查显示左心室-主动脉压力梯度为30 mmHg, Sellers分级为III级反流。测得主动脉瓣环小于19 mm。手术所见显示,主动脉瓣环似乎过小,无法植入19 mm的人工瓣膜。对主动脉瓣采用锉磨技术进行了主动脉瓣成形术(AVP),对二尖瓣进行了瓣膜置换。主动脉钳夹松开且患者恢复心跳后,经食管超声心动图对AVP的评估是有效的。术后过程平稳。术后心脏导管检查显示跨瓣压力梯度降至10 mmHg,主动脉反流为 Sellers I级。