Amano J, Suzuki A, Tanaka H, Sunamori M
Department of 2nd Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Int J Cardiol. 1998 Oct 1;66 Suppl 1:S197-202; discussion S203-4. doi: 10.1016/s0167-5273(98)00169-7.
Annuloaortic ectasia (AAE) associated with aortic regurgitation (AR) is a rare involvement in Takayasu arteritis. There are many difficult problems in surgical treatment of this lesion because of its inflammatory nature. We developed a composite graft repair technique to avoid complications associated with Bentall type procedures for treatment of AAE+AR. The technique consists of a double proximal suturing and direct coronary artery reimplantation as a Carrel patch without wrapping. Eight patients (one male, seven females) received this composite graft repair for treatment of AAE+AR due to Takayasu arteritis. Of them, two patients were in active phase. There was one hospital death probably due to ventricular arrhythmia, however, no late death occurred. And there were no late complications related to operative procedures. Thus, our composite graft repair technique for treatment of AAE+AR in Takayasu arteritis can prevent major complications associated with Bentall type procedures. However, close serial follow-up, careful control of inflammation, and early detection and treatment of other vascular involvements are necessary in the postoperative management of patients with Takayasu arteritis.
与主动脉反流（AR）相关的主动脉环扩张（AAE）在大动脉炎中较为罕见。由于其炎症性质，该病变的外科治疗存在诸多难题。我们开发了一种复合移植物修复技术，以避免与Bentall术式相关的并发症，用于治疗AAE+AR。该技术包括双重近端缝合和直接冠状动脉再植术，作为一种无包裹的卡雷尔补片。8例患者（1例男性，7例女性）因大动脉炎接受了这种复合移植物修复术治疗AAE+AR。其中，2例患者处于活动期。有1例医院死亡，可能是由于室性心律失常，但无晚期死亡发生。且没有与手术操作相关的晚期并发症。因此，我们用于治疗大动脉炎中AAE+AR的复合移植物修复技术可预防与Bentall术式相关的主要并发症。然而，在大动脉炎患者的术后管理中，密切的系列随访、仔细控制炎症以及早期发现和治疗其他血管受累情况是必要的。
