50例先天性主动脉窦瘤的外科治疗  

Surgical Treatment of Congenital Aneurysm of the Sinus of Valsalva

作　　者：于建华[1] 李守先[1] 李朝晖[1] 苏润毅[1] 宋惠民[1] 鲍继森[1] 

机构地区：[1]山东医科大学附属医院心外科

出　　处：《中华胸心血管外科杂志》1999年第1期4-6,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：总结先天性主动脉窦瘤外科治疗经验。方法：先天性主动脉窦瘤（ＣＡＳＶ）５０例，合并室间隔缺损３１例（６２％）、主动脉瓣脱垂１４例（２８％）。行窦瘤切除修补术１７例，窦瘤切除加室缺修补１９例，窦瘤切除加主动脉瓣成形１２例、主动脉瓣替换２例。结果：全组无手术死亡、无残余分流。结论：心脏超声对ＣＡＳＶ诊断准确率高。窦瘤破裂对心功能影响迅速而严重且预后较差。故一经确诊，宜尽早手术治疗，以及时纠正血流动力学紊乱。窦瘤破口直径＞１．０ｃｍ者宜用补片修补。缝合或修补窦瘤时进针方向要与主动脉长轴平行，并通过主动脉瓣环及其上缘的主动脉壁，以防止窦瘤复发或残余分流。Aim:To review the surgical experience in treatment of congenital aneurysm of the sinus of valsalva(CASV).Clinical matrial and method:Fifty patients with CASV were treated surgically from 1986 to 1996.There were 36 males and 14 females with a mean age of 26.1 years(range,5 to 59 years).The associated cardiac anomalies included ventricular septal defect(VSD)in 31(62%),aortic valve prolapse in 14(28%),atrial septal defect(ASD) in 3,obstruction of right ventricular outflow tract(RVOT) in 3,tricuspid or mitral valve regurgitation in 4,bacterial endocarditis in 1.Repair of aneurysm was performed in all patients.Concomitant procedures included valve replacement or valvuloplasty,repair of VSD and ASD,reconstruction of RVOT.Result:There were no operative deaths.The postoperative complications included acute respiratory failure in 1,incision infection in 2 and mild aortic insufficiency in 2.There were no residual shunt after surgery.42 patients were followed up for 1 month to 10 years.Clinical condition and cardiac function were improved significantly.Conclusion:Echocardiography is a very useful diagnostic tool for CASV.The CASV should be operated as early as possible to correct hemodynamic disturbance.Rupture of the aneurysm can result in serious deterioration of cardiac function and poor prognosis.

关 键 词：先天性 主动脉窦瘤 外科手术 

分 类 号：R543.160.5[医药卫生—心血管疾病]