应用reimplantation技术治疗妊娠中期马方综合征患者合并主动脉巨大根部瘤一例  

Application of reimplantation technique in treating Marfan syndrome and giant aortic root aneurysm during mid-pregnancy:A case report

作　　者：牛昊 钱宏[1] 宋海波[2] 杜磊[2] 余海[2] 张尔永[1] 肖正华[1] NIU Hao;QIAN Hong;SONG Haibo;DU Lei;YU Hai;ZHANG Eryong;XIAO Zhenghua(Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科,成都610041 [2]四川大学华西医院麻醉手术中心,成都610041

出　　处：《中国胸心血管外科临床杂志》2025年第3期416-420,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：马方综合征患者妊娠合并主动脉根部瘤是导致孕产妇终止妊娠甚至死亡的最主要原因之一,其中极少数孕妇需要在体外循环下实施保留妊娠的心脏手术,而手术均采用主动脉根部置换的手术方式。本研究报道1例30岁主动脉瓣重度反流合并主动脉巨大根部瘤,并处在妊娠中期的马方综合征高危患者。通过多学科合作模式,采用reimplantation技术行保留瓣膜的主动脉根部置换,不但实现了患者继续妊娠的愿望,还避免了机械瓣膜置换带来的抗凝及出血并发症,降低了妊娠风险并提高了远期生活质量。术后患者超声心动图提示主动脉瓣微量反流,主动脉瓣对合高度0.6 cm,有效高度1.1 cm,主动脉最大流速1.4 m/s,平均跨瓣压差4.4 mm Hg,临床效果满意。Pregnancy complicated by aortic root aneurysm in patients with Marfan syndrome is one of the main causes of termination of pregnancy or even death in pregnant women.A very small number of pregnant women require cardiac surgery to preserve pregnancy under extracorporeal circulation,and all surgeries use aortic root replacement.We reported a 30-year-old patient with severe aortic regurgitation combined with giant aortic root aneurysm and Marfan syndrome in mid-pregnancy.Valve-sparing root replacement using reimplantation technology was performed via a multidisciplinary cooperation model.This not only achieved the patient’s desire to continue pregnancy but also avoided the anticoagulation and bleeding complications brought by mechanical valve replacement,reduced pregnancy risks and improved long-term quality of life.Postoperative echocardiography showed a small amount of aortic valve regurgitation,aortic valve coaptation height of 0.6 cm,effective height of 1.1 cm,maximum aortic flow velocity of 1.4 m/s,mean transvalvular pressure gradient of 4.4 mm Hg,and satisfactory clinical results.

关 键 词：马方综合征 妊娠期 保留瓣膜的主动脉根部置换手术 动脉瘤 病例报告 

分 类 号：R714.252[医药卫生—妇产科学]