Kochi K, Yamazaki K, Ishii O, Komiya T, Nakamura T, Kanzaki Y
Heart Institute, Kurashiki Central Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Jan;45(1):84-7.
A case of extracardiac noncoronary sinus Valsalva aneurysm was reported. A 11-year-old male with history of mild AR was admitted to the hospital due to severe AR. Echocardiography revealed that the severe AR and an aneurysm in the posterior part of the ascending aorta. Angiography revealed that the origin of the aneurysm was noncoronary sinus. Operative findings showed that the aneurysm sized 23 mm by 25 mm was an extracardiac type which grew posteroinferiorily at the left side of noncoronary sinus and that the dilation. Neither aortic valve nor the aortic route showed degenerative change. The ptosis of the valvular ring due to aneurysmal dilation of the noncoronary sinus caused AR. Then, valve repair composed by commissuroplasty and commissural suspension was carried out. And intraluminal patch closure technique in which the longitudinal diameter of patch was half of that of the aneurysm was effective on suspension of the valvular ring. Postoperative echocardiography showed decreasing of AR.
报道了一例心外非冠状动脉窦Valsalva动脉瘤病例。一名有轻度主动脉反流病史的11岁男性因严重主动脉反流入院。超声心动图显示严重主动脉反流及升主动脉后部有一动脉瘤。血管造影显示动脉瘤起源于非冠状动脉窦。手术所见显示，一个大小为23毫米×25毫米的动脉瘤为心外类型，在非冠状动脉窦左侧向后下生长且有扩张。主动脉瓣和主动脉路径均未显示退行性改变。非冠状动脉窦动脉瘤样扩张导致瓣环下垂，引起主动脉反流。然后，进行了由瓣叶交界成形术和交界悬吊术组成的瓣膜修复术。采用补片纵向直径为动脉瘤纵向直径一半的腔内补片闭合技术对瓣环悬吊有效。术后超声心动图显示主动脉反流减轻。
