Homologous valved tube aortic root replacement

In 1972, Ross first applied the same kind of valved aorta to the clinic and replaced the aortic root. Subsequent replacement of the aortic root with a valved autologous pulmonary artery was successful. Curing disease: Indication Complex diffuse aortic stenosis and aortic annulus dysplasia. Preoperative preparation In addition to general routine procedures for open heart surgery, two-dimensional echocardiography and color Doppler examination should be performed before surgery to understand the pathological anatomy of the aortic valve, the size of the annulus and left ventricle, and whether or not the aortic regurgitation is combined. The extent of this in order to choose the appropriate surgical approach. Attention should be paid to monitoring the circulation, respiration and metabolism of critically ill infants before surgery. In the case of cardiac insufficiency, patients should be treated with diuretic diuresis. If necessary, positive inotropic drugs should be given. Newborn patients with critical illness need emergency treatment. Once the diagnosis is established, the prostaglandin E1 should be administered first through the central vein, the arterial catheter should be opened, and the right-to-left shunt of the transcatheter can be restored, which can reduce pulmonary hypertension and maintain systemic perfusion, so that it can be obtained from systemic low perfusion and acidosis. ease. These infants often need tracheal intubation and mechanical ventilation, and appropriate application of vasoactive drugs such as dopamine can help improve respiratory and circulatory function. Surgical procedure 1. The entire ascending aortic segment with thickening and hypoplasia is removed along with the aortic valve. When cutting to the right and the border of the non-crown valve, take care to avoid damage to the conduction beam, and the coronary artery is cut along with the same aortic wall. 2. The ventricular end of the allograft was sutured continuously to the ventricle with a 4-0 polypropylene thread, and then the left coronary artery was first transplanted to the same aorta using a 6-0 polypropylene thread. 3. The endo-end anastomosis of the same aorta and the ascending aorta is performed, and the right coronary artery is transplanted. 4, the completion of the two coronary artery transplantation, exclude gas accumulation in the heart chamber and aorta, open the ascending aortic obstruction forceps, gradually induce cardiac re-pulsation, stop extracorporeal circulation and routinely close the chest.