主动脉根包裹手术治疗主动脉根部动脉瘤  

Aortic root wrapped procedure treating with aortic root sinus aneurysm

作　　者：周子凡[1] 师启众[2] 刘现民 李鲁[4] 安卓翌[5] 周海波[6] 曹劝省[5] 宋士秋[1] 刘岸新[1] 李温斌[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心脏外科,100029 [2]新乡医学院第三附属医院心脏外科 [3]河南省安阳中医院心脏外科 [4]解放军306医院心胸外科 [5]河南科技大学第一附属医院心脏外科 [6]焦作矿务局中央医院心胸外科

出　　处：《心肺血管病杂志》2016年第3期196-199,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京高级卫生专家人才基金会(2009-3-44);国家自然科学基金(81070077)

摘　　要：目的：开发一个相对简单有效、手术风险较小的主动脉根部包裹术,以治疗主动脉根动脉瘤。方法：自2008年6月至2014年12月,25例主动脉根部瘤患者接受主动脉根部包裹术,其中合并主动脉瓣狭窄和/或反流者23例。主动脉瓣环的直径22-32mm,平均（26.30±3.45）mm,主动脉窦的直径45-62mm,平均（52.23±6.87）mm。所有患者进行主动脉根部包裹术,同时合并主动脉瓣成形术或置换术23例。结果：25例围手术期无死亡。CBP时间为55-128min,平均（81.56±15.43）min。出院前超声心动图检查结果显示：5例主动脉瓣轻度反流,20例主动脉瓣功能正常,与术前超声心动图结果对比,术后主动脉环直径21-25mm,平均（22.43±1.35）mm,较术前显著减小（P〈0.01）,主动脉窦直径30-52mm,平均（40.56±4.21）mm,显著减小（P〈0.001）。随访结果：所有25例患者生存良好,心脏功能（NYHA）均恢复I级,近中期无死亡病例。结论：主动脉根部包裹术结合主动脉瓣成型或置换术是一种外科手术治疗主动脉窦动脉瘤和主动脉瓣疾病新方法。Objective： To develop a relatively simple and effective and less risk operation,aortic root wrapped procedure,to treat with aortic root aneurysm or ectasia. Methods： From June 2008 to September2014,25 patients were accepted of aortic root wrapped angioplasty procedure,aortic sinus aneurysm with middle —severe aortic valve stenosis and / or regurgitation in 23 cases. The diameter of aortic valve annulus： 22-32（ 26. 30 ± 3. 45） mm,the diameter of aortic sinus 45- 62（ 52. 23 ± 6. 87） mm. All patients undertook aortic root wrapped angioplasty procedures with artificial blood vessel combined with aortic valve plasty or replacement with tissue valve prosthesis in 23 cases. Results： 25 patients were survival well,and the peri-operative mortality was 0%. CBP time was 55- 128（ 81. 56 ± 15. 43） minutes. Pre-discharge UCG check result was showed：trace aortic regurgitation in 5 cases,and normal aortic valve function in 20 cases; Comparing with pre-operative UCG results,aortic annulus diameter 21- 25（ 22. 43 ± 1. 35） mm,decreased significantly（ P〈0. 01）,aortic sinus diameter 30- 52（ 40. 56 ± 4. 21） mm,decreased significantly（ P〈0. 001）. Follow-up results： All 25 patients were survival well,and Heart function（ NYHA） of the patients are all Class I. The late mortality was 0.Conclusion： Aortic root wrapped procedures combined with aortic valve plastic or replacement operation is an alternative surgical procedure in patients with aortic sinus aneurysm and aortic valve disease.

关 键 词：主动脉根部包裹术 主动部根部瘤 主动脉瓣病变 

分 类 号：R54[医药卫生—心血管疾病]