升主动脉瘤的外科治疗分析

目的总结升主动脉瘤的外科治疗经验。方法23例主动脉根部病变患者（年龄22～55岁，平均31．8岁），其中Mafan’s综合征12例，Stanford A型主动脉夹层8例，主动脉瓣狭窄伴升主动脉扩张3例。手术类型：Bentall手术18例，Wheat手术3例，David手术1例，全弓置换加象鼻手术1例。结果全组手术死亡1例，术后随访12例平均41个月，无并发症。结论Bentall手术是治疗升主动脉瘤的主要术式，主动脉瓣叶正常，瓣膜轻度关闭不全，瓣环无明显扩张，David手术可以减少换瓣后服用抗凝药物所致的出血、血栓等并发症。

Obeservation on Surgical Treatment of Ascending Aortic Root Aneurysms

Objective To investigate the experience in surgical treatment of ascending aortic root aneurysms. Methods Twentythree cases（ age from 22 to 55 years,mean31.8years）with ascending aortic root aneurysms were diagnosed as having Marian syndrome （12 cases） , dissection aneurysms of type Stanford A （8 cases） , and aortic valve stenosis combined with ascending aortic ectasia（ 3 cases）. Our operations consist of 16 Bentall procedures, 3 Wheat procedures, 1 David procedure, and 1 total arch replacement and elephant trunk procedure.Results There was one case of operative death in the series. Follow-up was completed in 12 cases. During the follow-up （ average of 41 months） , there was no complicated diseases. Conclusion Bentall procedure is main treatment method of choice for ascending aortic root aneurysms. David operation may decreased incidents of blooding and thrombus after valve replacement.