主动脉窦瘤破裂的外科治疗

Cardiac surgical procedures of ruptured aortic sinus ancurysm

目的分析总结主动脉窦瘤破裂患者外科手术方法及临床治疗效果。方法回顾性分析2005年1月-2010年1月期间在我院心脏外科接受治疗的10例主动脉窦瘤破裂患者的临床资料。结果10例患者均在全麻低温体外循环下行主动脉类瘤破裂修补术，合并室间隔缺损、肺动脉辩狭窄术中一并矫治；3例中度主动脉瓣关闭不全行主动脉瓣成形术，1例重度主动脉瓣关闭不全给予主动脉瓣置换术。患者无围手术期死亡，且无远期死亡。术后患者心功能恢复到Ⅰ-Ⅱ级，手术取得较满意的效果。结论主动脉窦瘤破裂一旦确诊，手术治疗是唯一有效的方法，术中确切修补窦瘤和加强心肌保护是手术成功的关键，同时矫正合并的心脏畸形，可获得满意的近期和远期效果。

Objective： To summarize the clinic surgical methods and effect of ruptured aortic sinus aneurysm. Methods： From January 2005 to January 2010, 10 patients with ruptured aortic sinus aneurysm underwent surgical procedures.Results： 10 patients were in low descending aorta in general circulation withruptured repair, merge ventricular septal defect, Pulmonary artery stenosis treat together. 3 moderate aortic insufficiency aortic valvuloplasty, 1 cases of severe aortic regurgitation give aortic valve replacement. There were no deaths after the operation and during the follow-up.Postoperative cardiac function recovered to grade Ⅰ - Ⅱ, obtain satisfactory Results. Conclusions： Once diagnosed ruptured sinus , Surgery is the effective way, Intraoperative exact repair of sinus of valsalva and strengthen myocardial protection is the key to success, Also, the merger of cardiac anomaly orthodontic can obtain satisfactory immediate and long-term effects.