45例主动脉窦瘤破裂的外科治疗体会

Surgical treatment of 45 patients with ruptured aneurysm of the sinus of valsalva

目的:总结主动脉窦瘤破裂(RASV)的外科治疗经验。方法:回顾总结2000年12月至2010年5月先天性主动脉窦瘤破裂患者45例,所有患者均在全麻低体温体外循环下行主动脉窦瘤破裂修补术,同时行室缺修补术31例,主动脉成形术5例,主动脉瓣置换术6例,右心室流出道疏通6例。结果:全组死亡1例,痊愈出院44例,术后复查彩色超声心动图均未发现主动脉瘤复发或残余分流,随访3个月至6年所有患者心功能均有明显改善。结论:先天性主动脉窦瘤破裂患者一经确诊应积极尽早手术,手术过程中对窦瘤准确修复,加强心肌保护,以及对合并畸形的彻底矫治是手术成功的关键。

Objective：To review retrospectively the experience in surgical treatment of ruptured aneurysm of the sinus of valsalva（RASV）.Methods：From December 2000 to May 2010,45 patients with（RASV） accepted surgical treatment in our center were performed under moderate hypothermia with cardiopulmonary bypass.Concomitant procedures included VSD repair in 31 cases,AVP in 5 cases,AVR in 6 cases.Results：Among 45 cases,one hospital death occurred,44 patients were recovered uneveally.No recurrence or residual shunt was discovered during follow-up.Followed up for 3 months-6 years,cardiac function of the surrivors recovered to NYHAⅠ-Ⅱ.Conclusion：Following the diagnosis of ruptured aneurysm of sinus of valsalva,surgical repair shoud be performed as early as possible.Myocardial protection,precise repair of the defect and associated abnormalities are the the essential factors to the success of the surgery.