Aneurysm of the ascending aorta with aortic valvular insufficiency. Surgical management.
Aneurysm of the ascending aorta with aortic valvular insufficiency. Surgical management.
复制标题
升主动脉瘤伴主动脉瓣关闭不全。
DOI：
10.1001/archsurg.1966.01320220144023
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发表时间：
1966
影响因子：
--
通讯作者：
D. Cooley
中科院分区：
文献类型：
--
作者：
R. Bloodwell;G. Hallman;D. Cooley
与主动脉瓣关闭不全相关的升主动脉瘤是一种可怕的病理实体。动脉瘤的进行性扩张可能导致主动脉夹层或破裂伴致命性出血，并增加主动脉瓣扩张。1有效的外科治疗可缓解因瓣膜功能不全或冠状动脉灌注受损引起的心力衰竭和胸痛，并应防止致命性后果。整个升胸主动脉通常参与退行性过程，可能延伸到主动脉弓（图1）。在某些情况下，扩张局限于近端升主动脉，产生“佛罗伦萨瓶”畸形。伴随瓣环扩张，如主动脉瓣环扩张和囊状中膜坏死，2，3将导致主动脉瓣反流，而主动脉瓣叶无病理改变。成功的外科治疗包括矫正主动脉瓣关闭不全和切除动脉瘤并恢复主动脉连续性。这
ANEURYSM of the ascending aorta associated with aortic valve incompetence is a formidable pathologic entity. Progressive expansion of the aneurysm may result in both aortic dissection or rupture with fatal hemorrhage and increasing aortic valvular regurgitation.1Effective surgical therapy would relieve cardiac failure and chest pain due to valvular incompetence or compromised coronary artery perfusion and should prevent fatal consequences. The entire ascending thoracic aorta is often involved in the degenerative process which may extend into the aortic arch (Fig 1). In some cases the dilatation is confined to the proximal ascending aorta producing a "Florence flask" deformity. Accompanying annular dilatation, as in the cases with annuloaortic ectasia and cystic medial necrosis,2,3will result in aortic valvular regurgitation without pathologic changes in the aortic leaflets. Successful surgical management includes both correction of the aortic valvular insufficiency and excision of the aneurysm with restoration of aortic continuity. This has