摘要
手术治疗升主动脉瘤合并主动脉瓣关闭不全５例。主动脉造影示升主动脉扩张呈梨形，长９～１１．７ｃｍ，直径６～８ｃｍ。４例伴中至重度主动脉瓣关闭不全，１例为主动脉瓣狭窄与关闭不全。心功能Ⅱ级２例，Ⅲ级３例。切除升主动脉瘤，４例做主动脉根置换（Ｂｅｎｔａｌｌ手术），１例分别置换升主动脉和主动脉瓣。术中吻合口出血和术后心包内明显渗血各１例均治愈，全组病例康复出院，随访３～２４个月，症状消失、心功能均改善为Ⅰ级。重点讨论了有关手术指征、心肌保护、手术方式和术中注意事项。
Surgical management of 5 patients with ascending aortic aneurysm(AAA)and aortic insufficiency (AI)was reported. There were 3 males and 2 females. The age ranged from 23 to 37 years. Allpatients suffered from palpitation,dyspnea or dizziness,2 had chest pain,Cardio-thoracic ratio varied from0. 54 to 0. 80. Aorticoangiography showed dilatatioii of ascending aorta,extending 9～11.7 cm long and 6～8cm in width.There was moderate to severe Al in 4 cases, and aortic stenosis (AS)with AI in onecase. 2 patients were in NYHA class Ⅱ and 3 cases were in class Ⅱ heart function. The operations wereperformed under cardiopulmonary bypass with moderate hypothermia and cardiac arrest by an intermittentcoronary perfusion of cold diluted oxygenated blood. After resection of AAA, replacement of aortic root(Bentall operation)was performed in 4 cases, and refJlacement of aortic valve and asceIiding aorta in onecase. There was no operative death. Bleeding from the anastomosis site during the operation and oozing into the pericardial cavity postoperatively occurred in one ease cach. Both of them were controlled. All pa-tients were followed-up for 3 to 24 months. Their symptoms disappeared and cardiac function returned toclass I. The surgical indication,myocardial protectlon and operative techniques are discussed briefly。
出处
《解放军医学杂志》
CAS
CSCD
北大核心
1995年第4期267-269,共3页
Medical Journal of Chinese People's Liberation Army
关键词
主动脉
动脉瘤
主动脉瓣
关闭不全
外科手术
aortic disecting aneurysm
aortic insufficiency
marfan's syndrome
surgicaI manegement
