首页> 外文期刊>Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia >Endarterectomy and graft replacement of severely calcified (porcelain) ascending aorta with coronary ostial involvement in a patient requiring aortic valve replacement.
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Endarterectomy and graft replacement of severely calcified (porcelain) ascending aorta with coronary ostial involvement in a patient requiring aortic valve replacement.

机译:在需要置换主动脉瓣的患者中,进行严重钙化(瓷)升主动脉的动脉内膜切除术和移植物置换。

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摘要

We report a successful aortic valve replacement within an extensively calcified (porcelain) aorta, involving the left coronary artery ostium. Clamping such an aorta can result in embolization, dissection, and mural laceration. A 72-year-old female presented with a severely calcified and stenotic aortic valve with a peak pressure gradient of 101 mmHg. Computed tomography demonstrated extensive calcification of the ascending aorta. Coronary angiogram showed a 50% ostial left coronary artery stenosis. Under deep hypothermic circulatory arrest, the aorta was transected at the proximal arch and distal graft anastomosis was performed. This was followed by endarterectomy of the porcelain ascending aorta and the left coronary ostium. Aortic valve replacement, proximal aortic graft anastomosis, and a coronary artery bypass grafting (CABG) with the left internal thoracic artery (LITA) anastomosed to the left anterior descending artery (LAD) were then performed in a sequential manner.
机译:我们报告在广泛钙化(瓷器)主动脉内累及主动脉瓣置换,涉及左冠状动脉口。夹住这样的主动脉会导致栓塞,解剖和壁裂伤。一名72岁的女性表现出严重钙化和狭窄的主动脉瓣膜,峰值压力梯度为101 mmHg。计算机断层扫描显示升主动脉广泛钙化。冠状动脉造影显示左冠状动脉狭窄占50%。在深低温热循环停止下,在近端弓处切开主动脉并进行远端移植物吻合。随后进行升主动脉和左冠状动脉口的动脉内膜切除术。然后,按顺序进行主动脉瓣置换,主动脉近端吻合和左胸内动脉(LITA)吻合至左前降支(LAD)的冠状动脉旁路移植术(CABG)。

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