主动脉根部和瓣膜置换术：瓣膜导管的应用课件

1、主动脉根部和瓣膜置换术：瓣膜导管的应用福建省心血管病研究所福建省立医院心外科 韩涛在主动脉瓣膜病变的病例中，病变常累及主动脉瓣环、主动脉窦、升主动脉等，需要对不同的病变部位、病变形式采用不同的手术方法进行治疗。2000年以来我科有866例病人行主动脉瓣置换手术，其中涉及主动脉根部升主动脉病变的患者251例。一、主动脉根部扩大、主动脉瓣关闭不全、马凡综合征等采用Bentall手术（147例）。手术特点： a、连续缝合主动脉瓣，自制主动脉带瓣导管。 b、左冠状动脉直接与人造血管缝合，不做纽扣式缝合。 c、用主动脉壁将人造血管带瓣导管包裹。二、主动脉根部无扩大，主动脉瓣关闭不全，升主动脉壁撕裂。采用

2、Cabrol（36例）。手术特点：a、将左右冠状动脉或左冠状动脉用8mm人造血管缝合。 b、主动脉带瓣导管间断缝合。 c、用主动脉壁包裹缝合带瓣血管，如不够则加用心包片。四、主动脉瓣狭窄伴关闭不全，升主动脉扩张。老年性主动脉瓣钙化（40例）。手术特点：a、主动脉瓣置换，间断缝合。b、升主动脉外用人造血管包裹。 五、主动脉窦部扩大，主动脉瓣正常。应用David手术（3例）。手术特点：a、常规 David 手术b、升主动脉包裹人造血管 Aortic root and valve surgery: on aortic valve conduit applicationDepartment of Ca

3、rdiovascular SurgeryFujian Provincial Cardiovascular Disease Research InstituteFujian Provincial HospitalHan Tao Prof.The cases that suffered from aortic valve disease usually associated with the problems of aortic ring or aortic sinus or ascending aorta, the special surgical treatment should be app

4、lied according to different problems of aorta 866 cases received aortic valve replacement, and among them 251 cases accompanied with aortic root and ascending aorta disorders. Aortic dilatation , aortic regurgitation ,Marfans syndrome etc. Using Bentall procedure. (147 cases)Method: a:using running

5、suture in aortic valve replacement and own made valve conduit.b: left coronary artery anastomosed directly to the synthetic vessel, without using “button suture”. c: the prosthesis valve conduit wrapped with the remained wall of aorta The aortic valve regurgitation both with aortic root stenosis and

6、 ascending aortic dilatation.(25 cases)Method: a: to extend aortic root. to make incision between the left coronary sinus and non- coronary sinus, and then the mitral ring is broaden with pericardium.b: interrupt and running suture were combined.c: the dilated aorta restrained and wrapped with a pro

7、sthesis blood vessel.The aortic valve stenosis associated both with regurgitation and ascending aorta dilatation. The geratic aortic valve calcification.(40 cases)Method: a: using interrupt suture in aortic valve replacement. b: the aorta wrapped with a prosthesis vessel.The aortic sinus dilatation with normal aortic valve. Using David procedure. (3 cases) Method: a: routine David procedureb: the prosthesis blood vessel wrapped with the remained of aortic wall .Conclusion1. Shorten and simplified the surgical procedure 2. Bringi