先天性主动脉缩窄合并严重主动脉瓣病变的一次性外科矫治

Single-Stage Surgical Correction of Aortic Coarctation With Severe Aortic Valve Disease

目的 :探讨先天性主动脉缩窄合并严重主动脉瓣病变的外科治疗方法。方法 :采用升主动脉—腹主动脉人工血管转流术 +主动脉瓣置换术一次性治疗患者 9例 ,其中 4例对手术方法和体外循环技术进行了改进。结果 :术中死于体外循环意外 1例 ;术后部分肠梗阻 1例 ,8例患者痊愈出院。上肢收缩压术后较术前下降〔平均12 2 /78mmHgvs .178/6 5mmHg( 1mmHg =0 133kPa)〕 ,有显著性差异 (P <0 0 5 ) ,术后上、下肢血压无明显压差。左心室舒张末期内径术后较术前缩小 ( 4 9 40± 6 88mmvs .6 7 33± 17 2 9mm) ,有显著性差异 (P <0 0 5 )。结论 :该类患者采用升主动脉—腹主动脉人工血管转流术 。

Objective: To evaluate the surgical therapy of aortic coarctation with severe aortic valve disease. Methods: Nine patients underwent ascending-abdominal aortic bypass graft and aortic valve replacement. The techniques of operation and extracorpored circulation were modified successfully. Results: One died of the accident of extracorporeal circulation, One suffered from uncomplete postoperative intestenal obstruction and 8 survived the operation and left hospital. The blood pressure in the arms was evidently reduced and the blood pressure in the legs was elevated satisfactorily after the operation. Conclusion: It's safe, simple and effective for these patients to receive ascending-abdominal aortic bypass graft followed by aortic valve replacement under routine extracorporeal circulation.