南京医科大学学报（自然科学版）2012，Vol.32Issue(3)：414-417,4.
82例主动脉窦瘤破裂的外科治疗研究
Surgical treatment of ruptured sinus of Valsalva aneurysm in 82 patients
李倩 1刘林力 1陈立华 1于丁 1马千里 1刘苏1
作者信息
- 1. 河北医科大学第二医院心脏外科,河北石家庄050000
- 折叠
摘要
Abstract
Objective:To review retrospectively the surgical repair of sinus of Valsalva aneurysm (SVA) in 82 patients and summarize the clinic character and the surgical process of the SVA. Methods: Between May 1982 and May 2011,82 patients with SVA underwent surgical repair by the aid of general anesthesia and cardiopulmonary bypass,there were 63 male and 19 female patients aged from 12 to 59 years (mean,32.66 ± 14.28 years). The aneurysms originated from right sinus ruptured into the right ventricle in 48 patients,into the right atrium in 16 patients respectively. The aneurysms originated from noncoronary sinus ruptured into the right atrium in 18 patients. There were no aneurysms originated from left sinus ruptured into the left ventricle by now. The most common associated cardiovascular abnormality was ventricular septal defect (VSD,n = 39),and the other is aortic valve regurgitation (n = 23). Repairs were achieved through an incision in right atriotomy, right ventriculotomy or aortotomy only or both aortotomy and right atriotomy (or right ventriculotomy). The defects in the sinus of Valsalva was repaired with either direct sutures (n = 27) or a patch (n = 55). The aortic valve was replaced in 5 patients. The plasty of aortic valve was done in 16 patients. The mitral valve was replaced in 1 patient. The plasty of tricuspid valve was done in 8 patients. Results: There was no hospital mortality and all patients were cured. Twenty-seven patients underwent the repair surgery by direct suture. Fifty-five patients underwent the surgery by the patch. Five patients underwent the aortic valve replacement,and sixteen underwent aortic valve plasty. One hemoglobinuria was cured after the AVR operation. There was one reoperation for closure of recurrent fistula at the first day after the original operation. The patients who had reoperation had right sinus of Valsalva-to-right atrium fistulas. Another two mild fistulas were still in clinical observation. There are still four patients with mild aortic insufficiency after the surgery. There was another aortic valve plasty for the morderate aortic insufficiency after the surgery. There was no late mortality in the follow-up. Seventy-five patients are in operatively New York Heart Association class I,and 8 are in class II. Conclusions: The ruptured sinus of Valsalva aneurysm with or without the other cardiac abnormal should be repaired surgically as soon as the diagnosis was confirmed. The operative procedure depends on the size of the aneurysm,the direction of the tistula and the toughness of the surrounding tissue. It is necessary to close the defect of the aneurysm with the direct suture or the patch,from inside the aorta or the cardiac chamber,or from both sides of the tistula. Long-term results are excellent by the effective,appropriate operative procedure.关键词
主动脉窦瘤破裂/心脏外科手术/主动脉瓣关闭不全Key words
ruptured sinus of Valsalva aneurysm/cardiac surgery/aortic valve regurgitation分类
医药卫生引用本文复制引用
李倩,刘林力,陈立华,于丁,马千里,刘苏..82例主动脉窦瘤破裂的外科治疗研究[J].南京医科大学学报（自然科学版）,2012,32(3):414-417,4.
