Sakamoto S, Shimizu T, Aida H, Kaneto Y, Shirakawa N, Toyoda T
Rinsho Kyobu Geka. 1989 Apr;9(2):157-61.
Aortic valve endocarditis is frequently associated with an aortic root abscess, so that it is difficult to insert a prosthetic valve. Between April, 1983 and June, 1988 we treated four out of seven patients with aortic valve endocarditis by translocation of the aortic valve, closure of the native coronary ostia, and placement of saphenous vein grafts on the coronary arteries. In each case, the operation was undertaken because of rapidly progressing heart failure. Infection was due to alpha-Streptococcus in two instances, to Staphylococcus epidermidis and fungus in the other cases. In one of the four patients, the prosthetic aortic valve was sutured to the ascending aorta and two saphenous vein grafts were placed on the proximal coronary arteries. In the other three patients, the composite Woven Dacron graft was used to replace the ascending aorta and two saphenous vein grafts were placed on the distal coronary arteries. One patient died one year postoperatively of LOS because of rapidly progressing coronary grafts ostial stenosis. The other three patients survived and doing well with satisfactory hemodynamic function and no infection. Translocation of the aortic valve for infective aortic valve endocarditis is a useful operative technique when conventional aortic valve replacement technique cannot be utilize.
主动脉瓣心内膜炎常伴有主动脉根部脓肿，因此难以植入人工瓣膜。1983年4月至1988年6月期间，我们对7例主动脉瓣心内膜炎患者中的4例采用了主动脉瓣移位、封闭自身冠状动脉开口以及在冠状动脉上植入大隐静脉移植物的方法进行治疗。在每一例中，手术均因心力衰竭迅速进展而进行。感染原因在2例中为甲型链球菌，在其他病例中为表皮葡萄球菌和真菌。在4例患者中的1例，人工主动脉瓣缝合于升主动脉，两根大隐静脉移植物置于冠状动脉近端。在另外3例患者中，采用复合编织涤纶移植物置换升主动脉，两根大隐静脉移植物置于冠状动脉远端。1例患者术后1年因冠状动脉移植物开口迅速狭窄导致的 LOS 死亡。其他3例患者存活，血流动力学功能良好，无感染。当无法采用传统的主动脉瓣置换技术时，主动脉瓣移位治疗感染性主动脉瓣心内膜炎是一种有用的手术技术。
