主动脉瓣环扩大成形术在小主动脉瓣环主动脉瓣置换中的应用  

Aortic annuloplasty of smaller aortic annulus during aortic valve replacement

作　　者：李学文[1] 王宗超[1] 张国安[1] 蔡振杰[1] 

机构地区：[1]陕西省人民医院心脏外科,西安710068

出　　处：《陕西医学杂志》2010年第10期1313-1315,共3页Shaanxi Medical Journal

摘　　要：目的：探讨小主动脉瓣环病变患者行瓣环扩大术后置换主动脉瓣的临床疗效,手术方法及手术适应证。方法：对18例主动脉瓣病变伴主动脉瓣环狭窄患者行主动脉瓣置换加瓣环扩大成形术,其中采用K onno法6例,N icks法2例,M anougn ian法10例,同期处理合并病变。结果：全组18例死亡1例。死亡原因,M anougu ian法及二尖瓣置换、三尖瓣成形术,术后20d因二尖瓣周漏再次行瓣周漏修补术,术后第4天因多脏器衰竭诱发室颤而死亡。其余17例患者术后早期并发症有：频发室性早搏2例,室上性心动过速1例,经治疗后均痊愈。III°房室传导阻滞1例,经药物调理后心率维持在50~60次/m in,未安装永久起搏器,病人无不适出院。结论：只要术式选择恰当,对于小主动脉瓣环患者行主动脉瓣膜置换时,需行主动脉根部瓣环扩大术;扩大狭窄的主动脉瓣环是一种安全有效的方法,近、远期效果良好。Objective：The aim of this study was to confer the clinical results,surgical methords and indications of aortic annulus expansion and replacement in patients with small aortic annulus.Methods：18 aortic annulus expansion and replacement operated in aortic valve patients with aortic annulus stenosis,including 6 Konno＇s,2 Nick＇s,10 Manougnian＇s,combined diseases treated simultaneously.Results：In 18 patients,1 died from MODS in 4 days after second time operation for mitral valve leakage,that taked 20 days after first operation with Manouguian＇s,mitral valve replacement and tricuspid valve patch.Other earlier complications： 2 frequent premature ventricular contractions,1 supraventricular tachycardia was cured after treated,1 third degree atrial ventricular block with heart rate 50-60 beats per minute.Conclusion：Aortic valve expansion and replacement is the secure and effective method to patients with can aortic valve stenosis,which produce good results by long-term follow-up.

关 键 词：主动脉瓣狭窄/外科学 @主动脉瓣环成形术 @主动脉瓣置换 

分 类 号：R654.2[医药卫生—外科学]