Surgical treatment of left ventricular outflow tract obstruction with apicoaortic valved conduit.
Surgical treatment of left ventricular outflow tract obstruction with apicoaortic valved conduit.
复制标题
心尖主动脉瓣导管手术治疗左心室流出道梗阻。
作者：
Cooley Da;John C. Norman;G. Reul;Kidd Jn;M. Nihill
从1975年8月13日到1976年5月，9名患者接受了左心室“通风口”的创建，以缓解严重的左心室流出道阻塞。一个含有异种瓣膜的涤纶织物移植物被用来建立从左心室到腹主动脉的导管。本组患者男5例，女4例；他们的年龄从4岁到72岁不等。所有患者均有瓣主动脉狭窄、瓣下主动脉狭窄或瓣上主动脉狭窄，除两人外均曾接受过外科手术以缓解狭窄。所有患者手术后都存活了下来，没有人接受抗凝治疗。目前所有患者均无症状，随访时间接近一年。术后心导管检查显示主动脉瓣梯度降低约90%，平均心室收缩压降低45%。虽然这一概念并不新鲜，但并未得到广泛使用，我们认为其有效性值得进一步应用。
From Aug. 13, 1975, through May, 1976, nine patients underwent creation of a left ventricular "vent" for relief of severe left ventricular outflow tract obstruction. A Dacron fabric graft containing a heterograft valve was used to establish a conduit from the left ventricle to the abdominal aorta. There were five male and four female patients in this group; their ages ranged from 4 to 72 years. All had valvular, subvalvular, or supravalvular aortic stenosis, and all but two had undergone previous surgical procedures for relief of the stenosis. All patients survived the operation and none are receiving anticoagulant therapy. All are asymptomatic at present and follow-up is approaching one year. Postoperative cardiac catheterization studies revealed gradients across the aortic valve to be reduced by approximately 90% and mean ventricular systolic pressures by 45%. Although this concept is not new, it has not been used widely and we believe its effectiveness warrants further application.