主动脉窦瘤破裂的外科治疗体会

目的探讨主动脉窦瘤破裂的外科治疗经验。方法 69例主动脉窦瘤破裂患者在全麻体外循环下行主动脉窦瘤破裂修补术,同期行室间隔缺损修补41例,房间隔缺损修补6例,主动脉瓣成形8例,主动脉瓣置换4例。结果全组无手术死亡、残余分流,所有患者均得到随访,随访时间5个月～6年,平均随访27.6个月,心功能Ⅰ～Ⅱ级,复查心脏彩超无主动脉窦瘤复发或残余分流,主动脉瓣成形术后有2例轻-中度反流。结论外科手术是主动脉窦瘤破裂的有效治疗方法,修补技术是防止术后窦瘤复发、残余分流或主动脉瓣关闭不全发生的关键。

The experience of treatment to aneurysm of valsalva sinus reputure by surgery

Objective To summarize the experience of treatment aneurysm of valsalva sinus reputure by surgery.Methods We retrospectively analyzed the clinical data of 69 patients who were treated through repair the reputure of aneurysm of valsalva sinus on extracorporeal circulation,and 41 patients were done ventricular septal defect repaired,5 paients were done atrial septal defect repaired,8 paitents were done aortic valve forming,and the other 4 patients were replaced the aortic valves.Results All patients were alive,and no shunting after operation.The follow-up study continued from 5 months to 6 years after operation,and 27.6 months at average.There were no residual shunt,and no patient got aneurysm of valsalva sinus recur.Only two paitents had aortic insufficiency lightly after doing aortic valve forming.Conclusion It is a safe and effective therapeutic method to treat the paitents of aneurysm of valsalva sinus reputure.The key point of the technique was to prevent the aneurysm of valsalva sinus recur,residual shunt,and aortic insufficiency.