Abstract:
In this case report, we describe the surgical treatment of a right coronary sinus aneurysm. A 69-year-old male patient was screened because of palpitations. He was finally diagnosed with an aneurysm of the sinus of Valsalva of the right coronary cusp. According to current aortic guidelines, surgical reconstruction was proposed. The patient underwent a cardiac operation through a median sternotomy under routine cardiopulmonary bypass. After aortic cross-clamping, the aorta was opened and the connection between the aorta and the aneurysm was clearly visualized, underneath the ostium of the right coronary artery. After excision of the right coronary button and the remaining right coronary sinus wall, this sinus was reconstructed with a Dacron graft, with subsequent coronary reimplantation. The postoperative course was uneventful. The patient was discharged on postoperative day 7. A complete sinus reconstruction was preferred over local patching of the defect because of the proximity of the aneurysm sac to the right coronary artery and the fragile, thin aortic tissue just underneath the coronary ostium.
摘要:
在这个案例报告中,我们描述了右冠状窦瘤的手术治疗。一名69岁的男性患者因心悸而接受了筛查。他最终被诊断出患有右冠状动脉尖Valsalva窦的动脉瘤。根据目前的主动脉指南,提出了外科重建。患者在常规体外循环下通过正中胸骨切开术进行了心脏手术。主动脉交叉钳夹后,主动脉打开,主动脉和动脉瘤之间的连接清晰可见,在右冠状动脉口的下面.切除右冠状动脉纽扣和剩余的右冠状窦壁后,这个鼻窦是用涤纶移植重建的,随后的冠状动脉再植入。术后病程顺利。患者在术后第7天出院。由于动脉瘤囊靠近右冠状动脉且脆弱,因此完整的窦房结重建优于缺损的局部修补,冠状动脉口下面的薄主动脉组织。