主动脉窦瘤的外科治疗策略  

Surgical treatment strategy for sinus of valsalva aneurysms

作　　者：陈宏[1] 陈苏伟 王盛宇[1] 李岩[1] 孟旭[1] CHEN Hong;CHEN Suwei;WANG Shengyu;LI Yan;MENG Xu(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

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9病房,400029

出　　处：《心肺血管病杂志》2021年第10期1050-1052,1062,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结主动脉窦瘤(SVA)的外科治疗经验。方法:回顾性分析2011年1月至2018年5月,北京安贞医院的22例SVA治疗结果。结果:平均年龄(38.2±13.7)岁,14例(63.6%)为男性。SVA分别起源于右冠窦18例(81.8%),无冠窦3例(13.6%),左冠窦1例(4.5%)。合并室间隔缺损11例(50.0%),合并主动脉瓣反流12例(50.0%)。1例(4.5%)出现脑梗死后脑死亡。剩余21例患者顺利出院。20例患者接受随访,随访完成率95.2%。平均随访时间58.1个月。2例死亡,17例存活。1例超声心动图提示主动脉瓣中度反流,患者拒绝再次干预。余下患者未见窦瘤复发或残余分流。心脏功能NYHA分级I~Ⅱ级。3~8年生存率为90.9%。结论:外科修复SVAs的远期预后良好。治疗方案应在充分评估SVAs大小、与周围组织的解剖关系、主动脉瓣反流情况及合并心脏病变后确定。Objective:This study aims to summarize the experience of surgical treatment of sinus of Valsalva aneurysms(SVA).Methods:From January 2011 to May 2018,22 cases of SVAs were treated in Beijing Anzhen Hospital.Results:Mean age was(38.2±13.7)years,14 cases(63.6%)were males.SVAs originated in right coronary sinus,no coronary sinus and left coronary sinus was 18 cases(81.8%),3 patients(13.6%)and 1 case(4.5%),respectively.There were 11 cases with ventricular septal defect and 12 cases with aortic valve insufficiency.One case(4.5%)died of stroke.21 patients were discharged.20 patients were followed up,and the follow-up completion rate was 95.2%.The mean follow-up time was(58.1±28.3)months.2 death occurred during the follow-up,and 1 patient had moderate aortic regurgitation,but he refused further intervention.17 patients survived without SVA recurrence or residual shunt.Meanwhile,NYHA classⅠorⅡ.The overall survival was 90.9%from 3 to 8 years.Conclusions:The long-term prognosis for surgical repair of SVAs is good.Treatment options should be determined after adequate evaluation of SVAs size,relationship to surrounding tissues,aortic regurgitation,and coexisting cardiac lesions.

关 键 词：主动脉窦瘤 外科治疗 

分 类 号：R54[医药卫生—心血管疾病]