Bentall手术治疗升主动脉瘤14例报告

目的总结连续14例周升主动脉瘤伴主动脉瓣关闭不全行升主动脉及主动脉瓣复合带瓣人工血管置换、双侧冠状动脉开口移植手术(Bentall手术)无死亡的治疗体会。方法14例升主动脉瘤伴主动脉瓣关闭不全病例中13例行冠状动脉原位移植,对其中3例采用股动脉插管结合深低温停循环技术;另1例由于冠状动脉开口位置较低行Cabrol手术。结果14例病人均无手术死亡,术后平均引流720ml,平均住院28.5d,随访未发现远期并发症,心功能均恢复至Ⅰ~Ⅱ级。结论Bentall手术是治疗升主动脉瘤伴主动脉瓣关闭不全的有效方法。

Surgical treatment of ascending aortic aneurysm by Bentall''''s procedure: report of 14 cases

Objective To revi ew our experience in surgical treatment of ascending aortic aneurysm (AAA) with ao rtic insuffi-ciency in 14 cases of by Bentall's procedure. Methods and Results A ll the patients underwent replacement of the ascending aorta and aortic valve w ith composite valved vascular prosthesis and received direct implantation of the aortic graft of the coronary orifices (Bentall's procedure) with satisfactory results. Five patients had ascending aortic dissection and 4 had typical Marfan 's syndrome. All the patients suffered severe aortic insufficiency while 2 had m itral insufficiency. Coronary orifices were implanted in situ in 13 cases while in 1 case, Cabrol's method was adopted. No death occurred during the surgery an d in the subsequent follow-up, and all the patients had good recovery. Conclusi on Bentall's procedure can be effective in the treat-ment of AAA with aortic ins ufficiency.