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頁籤選單縮合
題名 | Midterm Results of Aortic Valve Reconstruction for Congenital Aortic Stenosis with or Without Regurgitation=先天性主動脈狹窄合併或不合併閉鎖不全的成形術 |
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作者 | 邱英世; 詹智翔; 陳銘仁; 吳求森; 吳協兆; 胡珀元; 吳美環; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 41:2 民89.03-04 |
頁次 | 頁85-89+112 |
分類號 | 417.62312 |
關鍵詞 | 先天性主動脈瓣狹窄; 單瓣性; 雙瓣性; 主動脈瓣重建術; 主動脈瓣閉鎖不全; Congenital aortic stenosis; Unicuspid; Bicuspid; Aortic valve reconstruction; Aortic regurgitation; |
語文 | 英文(English) |
中文摘要 | 主動脈瓣狹窄在氣球擴張術失敗之後常被施行瓣膜置換手術。我們由1993年8月至1999年8月間在4句患孩,年齡由1個月至15歲(平均8.3歲)施行主動脈瓣膜成形術。其中3名爲單瓣狹窄,1名爲雙瓣狹窄。有2例合併開放性動脈導管,1例肺動脈狹窄,另1例主動脈瓣閉鎖不全。有3例瓣膜融合處切開呈三瓣,另1例保持兩瓣。有1例切除萎縮之瓣膜後用自體心包膜補上,並重建其膨之外形與伏氏竇,如此可以將原來中度之主動脈瓣臘閉鎖不全變成極輕度。在追蹤期56.8±34.3個月當中用蔔勒測得之壓力差由開刀前88±36厘米汞柱降到20±26厘米汞柱,而且只有伴隨輕度閉鎖不全,所有病人狀況良好。我們結論認爲即使有閉鎖不全或單瓣性主動脈瓣狹窄的一部分病例仍可施行修補術。 |
英文摘要 | Aortic valve is often replaced if valvular stenosis fails to be balloon dilated. Aortic valve reconstruction was performed on 4 patients from August 1993 to1999. Their ages ranged from I month to 15 years (mean 8.3 years). Unicuspid aortic valve was present in three of them and bicuspid in the other one. Two patients were associated with a patent arterial duct, one aortic regurgitation, and one pulmonary stenosis. Commissurotomy was done in three of them to transform the aortic valve into tricuspid except one, in whom bicuspid valve was preserved. In one case with unicuspid aortic valve, a piece of tanned autologous pericardium was used to augment one myxomatous and retracted leaflet. The sinus of Valsalva was molded together with a bulging shape of its aortic leaflet. All four were weaned from cardiopulmonary bypass smoothly. Transesophageal echocardiography in one case prompted rebypass to decrease the degree of regurgitation from moderate to mild by further shaping of the leaflet and sinus of Valsalva. In one patient chylopericardium was complicated and subsided in 5 days after conservative treatment. All patients were doing well on follow up at 56.8±34.4 months after surgery, with trivial to mild systolic pressure gradient (20±26 mmHg; preoperatively: 88±36 mmHg) and mild regurgitation. Aortic valve reconstruction is feasible in the setting of congenital aortic stenosis in our limited experience; repair instead of replacement is recommended even when regurgitation is present. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。