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首页> 外文期刊>Khyber Medical University Journal >SURGICAL REPAIR OF RUPTURED SINUS OF VALSALVA ANEURYSM: EXPERIENCE AT CARDIOVASCULAR DEPARTMENT, LADY READING HOSPITAL, PESHAWAR
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SURGICAL REPAIR OF RUPTURED SINUS OF VALSALVA ANEURYSM: EXPERIENCE AT CARDIOVASCULAR DEPARTMENT, LADY READING HOSPITAL, PESHAWAR

机译：静脉曲张破裂性静脉窦的外科修复：心血管部门，女士阅读医院，PESHAWAR的经验

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Objectives: To determine the frequency of ruptured sinus of Valsalva aneurysm (SVA) and to study its surgical outcome in terms of morbidity and mortality in our set up.Methodology: This case series study was conducted on 23 patients of ruptured SVA’s, were operated at cardiovascular department, Lady reading hospital, Peshawar, from January 2003 to December 2011 and followed up till December 2013. Informed consent was taken from all patients. Surgical repair was performed using cardiopulmonary bypass (CPB) via a median sternotomy. Age, sex, presentation, site and outcome of surgical repair were analyzed.Results: Ruptured SVA’s was more common in males (73.91%). Right coronary cusp was involved in 86.95% patients of the ruptured SVA’s cases. Most common ruptured site was right ventricle (91.30%). Aortic regurgitation was observed in 21.73% and ventricular septal defects in 13.04% cases. Primary closure of the defect with pladgeted stiches done in 86.95% cases while patch closure was done in 13.05% cases. Preoperatively, 34.78% & 52.17% patients were having NYHA functional status III & IV respectively, while postoperatively 45.45% & 36.36% patients were having NYHA functional status I & II respectively. Mortality was 4.35% (n=1/23) and one (4.35%) patient had residual leak and managed conservatively. Two years follow up showed no complication regarding ruptured SVA.Conclusions: SVA are very uncommon anomalies in our setup, commonly involve right coronary cusp and rupturing mostly into right side of heart. Surgical repair of VSA is a safe procedure having good outcome in terms of morbidity and mortality.
机译：目的：确定Valsalva动脉瘤（SVA）破裂窦的频率，并从发病率和死亡率方面研究其手术结局。方法：本病例系列研究对23例SVA破裂的患者进行了手术。于2003年1月至2011年12月在白沙瓦夫人读书医院心血管部门进行随访，直至2013年12月。所有患者均获得知情同意。使用心肺旁路术（CPB）通过正中胸骨切开术进行手术修复。分析了年龄，性别，表现，部位和手术修复的结果。结果：破裂的SVA在男性中更为常见（73.91％）。 SVA破裂病例中，有86.95％的患者患有右冠状动脉尖。最常见的破裂部位是右心室（91.30％）。主动脉瓣反流占21.73％，室间隔缺损占13.04％。初次闭合缺损并用平刺缝合的病例为86.95％，而闭合修补的病例为13.05％。术前分别有34.78％和52.17％的患者具有NYHA功能状态III和IV，而术后45.45％和36.36％的患者分别具有NYHA功能状态I和II。死亡率为4.35％（n = 1/23），其中一名患者（4.35％）残余渗漏且保守治疗。两年的随访未发现SVA破裂的并发症。结论：SVA在我们的装置中是非常罕见的异常，通常累及右冠状动脉尖并破裂至心脏的右侧。 VSA的手术修复是一种安全的方法，在发病率和死亡率方面均具有良好的效果。

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