大动脉炎导致主动脉瓣关闭不全的外科治疗  

Surgical treatment for aortic regurgitation caused by aortitis

作　　者：孙立忠[1] 刘永民[1] 胡盛寿[1] 常谦[1] 朱俊明[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院外科,北京100037

出　　处：《中华胸心血管外科杂志》2003年第3期129-130,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　探讨大动脉炎导致主动脉瓣关闭不全的外科治疗方法。方法　 1990年 12月至2 0 0 2年 7月 ,手术治疗大动脉炎致主动脉瓣关闭不全 2 0例 ,12例行主动脉瓣机械瓣置换术 (AVR) ;8例行主动脉根部置换术 (ARR) ,包括Bentall术 5例 ,Carbrol术 2例 ,David术 1例。结果　全组无手术死亡。平均随访 ( 2 4 14± 2 1 12 )个月 ,最长 6 1个月。术后发生瓣周漏或瓣撕脱 7例 ,全部为AVR术后。再次手术 7例 ,其中 3例因再次瓣周漏第 3次手术 ;死亡 4例 ,远期死亡率为 2 0 %。结论　恰当的手术时机、适宜的手术方法和长期抗炎治疗有助于提高大动脉炎导致主动脉瓣关闭不全病人的外科疗效。Objective: To evaluate the surgical results of aortic regurgitation caused by aortitis. Methods: Results: Between 1990 and 2002, 20 patients with aortic regurgitation caused by aortitis underwent surgery. The surgical procedures included aortic valve replacement in 12 patients and aortic root replacement in 8 (Bentall type operation in 5, Cabrol type operative in 2, and David type operation in one). Conclusion: There was no operative death. The follow-up duration ranged from 2 to 61 months (mean, 24 months). Postoperative perivalvular leakage and/or detachment of the prosthetic valve occurred in 7 patients after aortic valve replacement. 7 patients required re-operation, and 3 patients underwent third operation due to perivalvular leakage. There were 4 later deaths (20%). Conclusion: The timing for the operation, selection of operative procedure, and preoperative control of active inflammation were essential for successful treatment of aortic regurgitation caused by aortitis.

关 键 词：大动脉炎 主动脉瓣关闭不全 治疗 外科手术 

分 类 号：R654.2[医药卫生—外科学]