主动脉窦瘤破裂的外科治疗

Surgical treatment for rupture of aortic sinusal aneurysm

目的总结主动脉窦瘤破裂的外科治疗经验,以探讨其疾病特点及手术方法。方法16例患者(男9例、女7例)在中低温体外循环下行主动脉窦瘤修补术,9例患者同期行室间隔缺损修补术,3例同期行房间隔缺损修补术,1例同期行主动脉瓣成形术,2例同期行主动脉瓣替换术,其他1例。阻断时间(66.12±13.33)min,体外循环时间(101.42±37.49)min。结果本组病例无死亡。1例患者术后早期出现频发室性早搏、室性二联律,静脉滴注利多卡因有效。所有患者治愈出院,随诊无一例复发。结论主动脉窦瘤破裂是罕见的心脏疾病,尽早手术是惟一有效的治疗方法。采用主动脉及右心房或主动脉及右心室双切口利于心肌保护和确切修补主动脉窦瘤、纠正合并畸形。

Objective To summarize the experience of surgical treatment for rupture of aotic sinusal aneurysm during the past 10 years,then elucidate its pathological characteristics and surgical methods.Methods Surgical repair was performed under hypothermic anaesthesia with cardiopulmonary bypass in 13 patients,including 7 males and 6 females.Other cardiac malformations were corrected simutanneouly.Results There was no hospital mortality.Ventricular arrhythmias occurred in 1.All patients were recovered smoothly.No recurrence occurred during follow-up survey.Conclusions Rupture of aortic sinusal aneurysm is a rare cardiac anomaly.Surgical repair should be performed as early as possible.The repair may be performed through an aortotomy with cardiotomy,thus leading to an double incision between aorta and right atria or between aorta and right ventricular may permit effective myocardial protection and correction of concomitant heart malformations.