Page 210 - 先天性心脏病的导管术：从婴幼儿期到成人期

192 先天性心脏病的导管术：从婴幼儿期到成人期

免缝合和快速植入瓣膜是外科生物瓣膜植入的一种替代方法 [52] 。
外科主动脉瓣置换术的通用步骤仍然需要：胸骨切开或微创手术路径、肝素化、
体外循环、主动脉夹闭、心肌保护、升主动脉开口、病变瓣膜切除、主动脉环脱钙。
主动脉环脱钙应充分进行，以避免瓣周漏；然而，由于存在环破裂和出血的风险，不

推荐广泛脱钙。在处理免缝合线和快速植入瓣膜时，评估大小是至关重要的一步，以
避免瓣周漏、中央主动脉瓣反流、瓣膜移位和环破裂。因此，我们既不需要也不建议
过度评估。这种策略可能通过减少夹闭和体外循环时间来降低手术风险 [53,54] 。

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