摘要
目的:探讨主动脉瓣二叶式畸形(BAV)及合并升主动脉瘤样扩张的外科治疗方法。方法:2000年1月—2009年4月对28例主动脉瓣二叶式畸形患者行手术治疗,其中6例合并升主动脉瘤样扩张。其中,男性22例,女性6例,年龄23～65岁。心功能II级16例,III级9例,IV级3例。行主动脉瓣置换22例,行主动脉瓣置换和升主动脉置换(Wheats手术)2例,行主动脉瓣置换和外用Dacron人工血管展开后包绕升主动脉成形1例,3例应用带瓣管道行Bentall手术。同期行二尖瓣环置换术3例,三尖瓣成形术6例。结果:术后早期死亡1例,为Bentall手术后死于纵隔感染。术后早期并发低心输出量综合征6例,呼吸功能不全6例。痊愈出院27例,随访3个月～2年,无晚期死亡病例。结论:先天性主动脉瓣二叶式畸形可致主动脉瓣关闭不全或狭窄,主动脉瓣置换术是常用的手术方法。BAV合并升主动脉瘤样扩张要根据不同的病情作不同手术,可获得良好的结果。
Objective：To investigate the treatment and surgical results of congenital bicuspid aortic valve and ascending aortic dilation.Methods：From January 2000 to April 2009,a total of 28 patients with bicuspid aortic valve malformations underwent surgical treatment,6 cases of aortic valve malformation with ascending aortic dilation. 22 Male,6 females,aged 23 to 65 years old. Heart function Class II in 16 cases,Class III in 9 cases,IV in 3 cases. Aortic valve replacement in 22 cases,aortic valve replacement and ascending aorta replacement （Wheats surgery） in 2 cases,aortic valve replacement and external Dacron graft surrounding the ascending aorta in 1 case,three cases underwent Bentall operation. Results：Among 28 cases,22 underwent mechanical valve replacement and 6 underwent valve replacement ascending aorta surgery. There was 1 early operative death,one of the Bentall operation died of mediastinal infection after surgery. Early postoperative low cardiac output syndrome complicated with 6 cases,respiratory insufficiency in 6 cases. 27 cases discharged from hospital. No late deaths during the followup of 3 months to 2 years. Conclusions：Aortic valve replacement is the commonly used and effective treatment for most of the bicuspid aortic valve patients. Several different surgical options exist for patients with BAV disease depending on the age of presentation and the size and appearance of the aorta.
出处
《中国临床医学》
2010年第2期159-160,共2页
Chinese Journal of Clinical Medicine
关键词
二叶式
主动脉瓣
瓣膜置换
Bicuspid aortic valve
Cardiac valve replacement
