A new technique for sparing the aortic valve in patients with aneurysm of the ascending aorta and root.
A new technique for sparing the aortic valve in patients with aneurysm of the ascending aorta and root.
复制标题
一种保留升主动脉和主动脉瘤患者主动脉瓣的新技术。
DOI：
10.1016/s0022-5223(00)70104-8
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
U. Hvass
中科院分区：
文献类型：
--
作者：
U. Hvass
我们的新包含技术结合了几个优点。所有缝合线都位于主动脉环上方，便于手术入路，就像雅各布手术一样。主动脉根部得以保留，因此三小叶及其连接的空间组织受到的干扰最小，有助于理解和重建。涤纶管的大小完全根据测量的主动脉环直径而不是数学公式来选择，同时考虑到小叶的高度和自由边缘的长度。止血是通过缝合线的大咬口和在主动脉近端根部内封闭所有缝合线来保证的。最后，虽然患者数量仍然很少，但没有发生术后主动脉瓣反流的病例。在三种保留主动脉瓣的手术中，只有大卫手术可以重塑主动脉环。雅各布手术和目前的手术并不是为了缩小主动脉环而设计的，因此在主动脉环扩张和马凡氏综合征方面有相同的局限性。总之，涤纶管包裹体技术是有前景的。与其他技术相比，它具有更方便的环上缝合线，更容易重建原主动脉瓣和安全止血的优点。需要更多的案例来证实这种新方法的有效性。
Our new inclusion technique combines several advantages. All the sutures are placed above the aortic anulus, facilitating the surgical approach, as with the Yacoub procedure. The aortic root is preserved, and therefore the spatial organization of the three leaflets and their commissures is minimally disturbed, facilitating understanding and reconstruction. The size of the Dacron tube is selected solely on the basis of the measured diameter of the aortic anulus and not on mathematical formulas, taking into account the height of the leaflets and the length of their free margins. Hemostasis is ensured by the large bites of the running suture and furthermore by enclosing all the sutures within the proximal aortic root. Finally, although the number of patients is still small, there have been no instances of postoperative aortic valve regurgitation. Among the three operations described for preserving the aortic valve, only the David procedure could remodel the aortic anulus. The Yacoub procedure and the present operation are not designed to reduce the aortic anulus and therefore share the same limitations concerning annuloaortic ectasia and Marfan syndrome.In conclusion, the Dacron tube inclusion technique seems promising. Compared with the other techniques, it associates the greater facility of a supra-annular suture line, an easier reconstruction of the native aortic valve, and a secure hemostasis. More cases will be needed to confirm the validity of this novel approach.