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題名 | Aortic Root Pseudoaneurysm Following Surgery for Aortic Valve Endocarditis=續發於主動脈瓣膜心內膜炎手術的主動脈根部假性動脈瘤 |
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作者 | 蔡貴棟; 鄭乃仁; 朱肇基; 林萍章; Tsai, Kuei-ton; Cheng, Nye-jen; Chu, Jaw-ji; Lin, Pyng Jing; |
期刊 | 長庚醫學 |
出版日期 | 20020200 |
卷期 | 25:2 2002.02[民91.02] |
頁次 | 頁133-138 |
分類號 | 415.384 |
語文 | eng |
關鍵詞 | 主動脈瓣膜心內膜炎; 主動脈根部假性動脈瘤; 同種移植體主動脈根部置換; Aortic valve endocarditis; Aortic root pseudoaneurysm; Homograft aortic root replacement; |
中文摘要 | 主動脈瓣膜心內膜炎的手術治療仍以人工主動脈瓣膜置換術為主,通常這種方式即能治癒並恢復心臟功能;然而在合併主動脈環部周圍膿瘍等複雜情況,併發症可能一再產生,使得再度手術變的極為困難。 本文描述一成年男性,因主動脈瓣膜心內膜炎合併環部周圍大型膿瘍腔室,接受手術後三個月,在並無感染復發或人工主動脈瓣膜閉鎖不全的情況下,產生鬱血性心衰竭現象。經檢查發現在主動脈根部有一巨大假性動脈瘤,在隨後的手術中,以超低溫冷凍保存的主動脈瓣膜同種移植體成功地重建患者的左心室出口通道。術後恢復良好,目前已在門診追蹤兩年。 因感染性心內膜炎接受人工主動脈瓣膜置換術後,一經診斷即須立刻手術,同種移植體主動脈根部置換術在如此複雜病況下,被證實為一俱有良好療效的選擇。 |
英文摘要 | Prosthetic aortic valve replacement for aortic valve endocarditis remains a primary practice of most cardiac surgeons. Usually it cures endocarditis and restores cardiac function. However, in advanced aortic valve endocarditis with complex annular destruction, complications following prosthetic aortic valve replacement do occur and present a formidable challenge for reoperation. Herein, we describe a case of an adult man who was operated on inititally for advanced aortic valve endocarditis with a large periannular abscess cavity and who develop congestive heart failure 3 months later. Furthermore, he was diagosed with a giant pseudoaneurysm around the aortic root without evidence of recurrent infection or aortic prosthetic incompetence. During his reoperation, a cryopreserved aortic homograft as a root replacement that included reimplantation of bilateral coronary artery buttons was used to exteriorize this pseudoaneurysm and reconstruct a left ventriculat outflow tract. The postoperative course was unremarkable, and the patient, during a follo-up of 2 years, remained in New York Heart Association functional class I. Aortic root pseudoaneurysm following prosthetic aortic valve replacement for infective endocarditis is rare in clinical practice and can cause rapid hemodynamic deterioration which requires imminent reoperation. Homograft aortic root replacement has proven to be a versatile treatment option of this complex disease. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。