主动脉窦瘤的诊断及治疗

目的：探讨主动脉窦瘤的诊断及治疗方法。方法：回顾性分析2000年2月～2007年12月在我院诊治的28例主动脉窦瘤的临床资料。全部患者均在全身麻醉体外循环下行心内直视修补术，心肌保护采用经升主动脉根部顺行灌注或切开后经冠状动脉开口直接灌注冷血停跳液。右房切口4例，右室流出道切口9例．经主动脉直接缝合破口后再经心腔切口补片加强窦壁15例。其中12例同期行主动脉瓣置换术。结果：本组患者无手术死亡，术后因活动性出血二次开胸止血1例，切口感染1例，经换药处理治愈出院。随访3个月～5年。所有病人都自觉症状消失，心功能明显改善。能从事正常工作或一般体力劳动，无抗凝意外事件发生。结论：术前正确的诊断、术中选择恰当的手术方式是成功治疗主动脉窦瘤的关键因素。

Diagnosis and treatment of aneurysm of sinus of Valsalva

Objective： To explore the diagnosis and treatment of aneurysm of sinus of Valsalva. Methods： A retrospective study was taken to review 28 patients： who underwent aneurysm of sinus of Valsalva repair from february 2000 to december 2007 in our hospital. All patients underwent procedure under standard cardio-pulmonary bypass techniques. The cold blood eardioplegic solution was used and by antegrade perfusion through aortic root or direct perfusion through coronary incision. Right atriotomy was used in 4 cases, and right ventrieular outfow tract incision in 9 cases. Other 15 cases were sutured directly by aortotomy and then aneurysm wall was strengthened through heart chamber incision with patch. Concomitant aortic valve replacement was performed in 12 patients. Results： There was no hospital death among these patients. 1 case was reoperated for active bleeding. Incisional infection happened in 1 case and was cured. Followed up for three months to five years, all patients felt well and could afford normal work. No anticoagulant accident occurred. Conclusion： Correct preoperative diagnosis and proper operative mode are the key factors for successfully repair of aneurysm of sinus of Valsalva.