Konno术和改良Konno术在治疗严重左室流出道狭窄中的应用研究  

The application of Konno operation and modified Konno operation in severe left ventricular outflow tract stenosis

作　　者：李晓涛[1] 孙国成 雷军荣 王华[1] 陈卫国 Li Xiaotao;Sun Guocheng;Lei Junrong(Department of Cardiothoracic Surgery,Xi’an Gaoxin Hospital(Xi’an 710075))

机构地区：[1]西安高新医院心血管外科,西安710075 [2]空军军医大学西京医院心血管外科,西安710032

出　　处：《陕西医学杂志》2018年第8期1047-1049,共3页Shaanxi Medical Journal

摘　　要：目的:探讨Konno术和改良Konno术在治疗严重左室流出道狭窄病例中的应用价值。方法:对严重主动脉瓣下狭窄患者采用Konno术疏通左室流出道,并扩大主动脉瓣环及主动脉前壁,同时行主动脉瓣置换术;对肥厚梗阻型心肌病患者采用改良Konno术,进行左室流出道疏通。结果:手术均取得良好效果,术后患者症状均明显减轻或消除。术后复查心脏超声均未见室水平残余分流,左室流出道血流通畅,跨瓣压差明显下降,左室射血分数(LVEF)提高,心功能NYHA等级均较术前明显改善。随访3~20个月无晚期死亡,无再次手术。结论:对于各种原因所致的严重主动脉瓣下狭窄只有在传统术式不能足够扩大主动脉根部时,Konno术可有效扩大主动脉瓣环。对内科治疗无效的肥厚梗阻型心肌病,改良Konno术可有效疏通左室流出道,改善心功能,提高远期疗效,不失为最佳选择。Objecttive:To explore the application of Konno operation and modified Konno operation in severe left ventricular outflow tract stenosis.Methods:To open the left ventricular outflow tract and enlarge the aortic valve ring and the anterior wall of the aorta with the use of Konno operation.Simultaneous aortic valve replacement;The improved Konno operation was used for hypertrophic obstructive cardiomyopathy,and the left ventricular outflow tract was dredged.Results:All operations achieved good results,Postoperative symptoms of patients were significantly reduced or eliminated.Review postoperative cardiac ultrasound room level of residual shunt was not found,left ventricular outflow tract unobstructed,blood flow across the valve differential pressure decreases obviously,increased left ventricular ejection fraction(LVEF),cardiac function NYHA class than preoperative obviously improved.There was no advanced death and no reoperation after 3~20 months of follow-up.Conclusion:For the severe aortic valve stenosis caused by various reasons,Konno operation can effectively expand the aortic valve ring only when the traditional operation is not enough to enlarge the aortic root.The improved Konno technique can effectively dredge the left ventricular outflow tract,improve the cardiac function and improve the long-term curative effect,which is the best choice for the treatment of ineffectual hypertrophic cardiomyopathy.

关 键 词：主动脉瓣狭窄 室性流出道阻塞 @Konno术 

分 类 号：R654.2[医药卫生—外科学]