中文摘要：

目的总结主动脉窦瘤破裂并发急性心力衰竭患者急诊手术治疗的经验。方法主动脉窦瘤破裂患者36例，术前心功能分级（NYHA）为Ⅲ-Ⅳ级，经内科治疗6～48小时无效时采取急诊手术治疗。主动脉窦瘤破入右室16例，破入右房18例，破入左房2例。并发妊娠2例，室间隔缺损5例，主动脉瓣关闭不全24例，感染性心内膜炎7例。直接缝合3例，补片修补33例，同期行人工分娩1例，剖宫产1例，主动脉瓣成形5例，主动脉瓣置换19例。结果围手术期1例因发生严重低心排血量综合征而死亡，1例放置主动脉内球囊反搏后恢复，3例患者行短期血液透析治疗。术后随访无死亡，1例术前合并感染性心内膜炎的患者，术后6个月出现主动脉瓣大量返流再次手术治疗，1例主动脉瓣成形患者术后2年复查，发现主动脉瓣重度返流行主动脉瓣置换术。心功能恢复至Ⅰ级32例，Ⅱ级3例。结论主动脉窦瘤破裂并发急性心力衰竭急诊手术可获得满意的近期和远期疗效。

英文摘要：

Objective To summarize the experience of emergency surgical treatment on ruptured aneurysm of aortic sinus with acute heart failure. Methods A total of 36 patients with ruptured aneurysm of aortic sinus（ NYHA class Ⅲ to Ⅳ heart failure）underwent emergency surgical repair when the internal medicine treatment for acute heart failure was invalid after 6 -48 hours. The aneurysm ruptured into the right ventricle in 16 cases, right atrium in 18 cases, and left atrium in 2 cases. Combined diseases included presnancy in 2 cases, ventricnlar septal defect in 5 cases, aortic insufficiency in 24 cases, and endocarditis in 7 cases. The sinus aneurysm was repaired with a patch in 33 cases and direct sutures in 3 cases. Nine- teen cases received aortic valve replacement and five cases received valvuloplasty. Cesarean section and artificial labor were performed in one case, respectively. Results There was one death due to serious low cardiac output syndrome, while another recovered after the placement of intra-aortic balloon pump. Three cases were treated with short-term dialysis. There was no death during the follow-up. One patient with pre- operative infectious endocarditis received reoperation due to severe aortic valve regurgitation on the 6th month after operation. One patient with aortic valvuloplasty received aortic valve replacement due to severe aortic valve regurgitation on the 2nd year after operation. Cardiac function was restored to grade Ⅰ in 32 cases and grade Ⅱ in 3 cases. Conclusion The emergency surgical treatment for ruptured aneurysm of aortic sinus with acute heart failure shows good short-term and long-term results.