Late outcome after repair of aortico-left ventricular tunnel - 10-year follow-up
Late outcome after repair of aortico-left ventricular tunnel - 10-year follow-up
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DOI：
10.1253/circj.70.939
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发表时间：
2006-07-01
影响因子：
3.3
通讯作者：
Sano, S
中科院分区：
文献类型：
--
作者：
Honjo, O;Ishino, K;Sano, S
尽管成功的手术修复，先天性二尖瓣-左心室隧道（ALVT）患者在术后后期仍有发生主动脉瓣关闭不全的风险。两例ALVT随访10年，特别是主动脉瓣关闭不全和主动脉根部的几何形状。患者接受了ALVT修复术，1例在4岁时，另1例在4个月时。第1例患者出现裂缝样隧道（1型），用心包补片闭合主动脉瓣口。第二例患者有一个大隧道，有一个心外动脉瘤（H型），在主动脉口用心包补片闭合，在左心室口用涤纶补片闭合，从而完全闭塞隧道。最后一次超声心动图评价显示，例1隧道内无残余血流，无主动脉瓣关闭不全，但例2有轻度主动脉瓣返流伴右窦畸形。由于ALVT患者从左心室流出道到主动脉根部存在一些固有的结构异常，因此需要进行仔细的长期随访。
Despite successful surgical repair, patients with congenital aortico-left ventricular tunnel (ALVT) are at risk of developing aortic incompetence in the late postoperative period. Two cases of ALVT were followed for 10 years with special reference to aortic incompetence and geometry of the aortic root. The patients underwent repair of ALVT, one at 4 years of age and the other at 4 months of age. The first patient had a slit-like tunnel (type 1) and the aortic orifice was closed with a pericardial patch. The second patient had a large tunnel with an extracardiac aneurysm (type H) and was closed with a pericardial patch at the aortic orifice and a Dacron patch at the left ventricular orifice, thereby completely obliterating the tunnel. The last echocardiographic evaluation showed no residual flow in the tunnel and no aortic incompetence in case 1, but there was mild aortic valvular regurgitation with deformity of the right sinus in case 2. Careful long-term follow-up is necessary because patients with ALVT have some inherent structural abnormalities from the left ventricular outflow tract to the aortic root.