主动脉窦瘤破裂的外科治疗

Surgical treatment of rupture of aortic sinusal aneurysm

目的探讨主动脉窦瘤破裂的外科治疗。方法回顾性分析我院收治的9例主动脉窦瘤破裂患者的临床资料。结果男5例、女4例,年龄18～50岁,均在中低温体外循环下行主动脉窦瘤修补术,5例患者同期行室间隔缺损修补术,1例同期行房间隔缺损修补术,1例同期行主动脉瓣成形术,1例同期行主动脉瓣置换术。阻断时间74.11±30.35分钟,体外循环时间117.33±36.00分钟 。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,静滴利多卡因有效。所有患者治愈出院。结论主动脉窦瘤破裂尽早手术是唯一有效的治疗方法。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,利于确切修补主动脉窦瘤,纠正合并畸形。

ObjectiveTo study the surgical treatment of rupture aortic sinusal aneurysm.Methods9 cases of ruptureof aortic sinusal in our hospital were analyzed retrospectively. ResultsIn 9 cases,5 patients were male and 4 patients werefemale.The age range was from 18 to 50.Surgical repair which was under hypothermic anaesthesia with cardiopulmonarybypass was performed for all cases.Other cardiac malformations were corrected simultaneously.There was no case ofdeath.Ventricular arrhythmias occurred in 1 case.All patients recovered smoothly. No recurrence occurred during follow-upsurvey.ConclusionsThe operation should be taken as early as possible.Repair of aortic sinusal aneurysm through anaortotomy with cardiotomy can not only protect the myocardiac effectively but correct the concomitant heartmalformations.This approach reduce the rish of recurrence also.