摘要
自１９９３年９月至１９９５年６月，连续治疗５例马凡综合征病人。其中１例在住院期间瘤体破裂，严重心包填塞、休克，急诊行Ｃａｂｒｏｌ手术获得成功。采用带瓣人工血管作升主动脉及主动脉瓣替换（经典Ｂｅｎｔａｌ手术），冠脉移植采用一根中介人工血管，两端分别与左右冠状动脉开口作端—端吻合，中介人工血管再与置换的升主动脉人工血管作侧—侧吻合（Ｃａｂｒｏｌ手术）。５例病人均手术成功，心包纵隔引流总量７１０～１４７０ｍｌ，平均９４８ｍｌ。无二次开胸止血者。术后早期无死亡，随访３～２２个月，平均１０个月，心功能均为ＩＩ级，心电图与术前比较无显著变化，但心胸比率明显下降，超声心动图示左室较术前明显缩小。病理结果均为中层弹力纤维严重断裂，重度粘液变性。结论：Ｃａｂｒｏｌ手术是治疗马凡综合征主动脉根部病变的有效手术方法之一，特别适于冠状动脉开口移位较小的病人。
Aim:Aneurysm of ascending aorta,a lifethreatening disease can be treated by various surgical procedures.This retrospective study reports the experience of using Cabrol procedure in the management of this problem.Clinical material and method:From September 1992 to June 1995,five patients(all were males with a mean age of 36 years)with aneurysm of the ascending aorta and aortic insufficiency(DeBakey II in 2 and annuloaortic ectasia in 3)underwent Cabrol procedure under cardiopulmonary bypass(one patients received urgent operation because of rupture of aneurysm).The surgical procedures in all cases consisted of total replacement of the ascending aorta with a Dacron tube graft containing a prosthetic aortic valve and reimplantation of the coronary arteries by an intermediate tube graft.Results:There was no postoperative mortality or severe morbidity.Pathological sections of all resected aortic specimens revealed marked disruption of elastic fibers with severe mucous degeneration in the media.During 3 to 22 months(mean,10 months)follow up,Doppler echocardiogram revealed normal speed of blood flow in the intermediate coronary arterial prosthesis.Postoperative heart function improved from class III(n=3)and IV(n=2)to class II(NYHA).Conclusion:The treatment of aortic insufficiency associated with an aneurysm of the ascending aorta by insertion of a composite gratf and reimplantation of the coronary arteries through an intermediate Decron tube is a reliable method with low mortality and excellent results.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1998年第2期74-77,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
马方综合征
CABROL手术
主动脉根
Marfan's syndrome Aneurysm of ascending aorta Cabrol procedure
