Bentall 术治疗主动脉根部瘤21例临床分析

摘要

Objective To summarize the experience of Bentall operation for aortic root aneurysm .Methods 21 patients with ascending aortic root aneurysm underwent Bentall operation .Among the 21 cases,there were 14 cases of ascending aortic aneurysm and over moderate and severe aortic valve regurgitation ,1 case of ascending aortic aneurysm and over moderate and severe aortic valve stenosis,3 cases of Marfan syndrome,and 3 cases of acute dissecting aortic aneurysm.Before operation,2 cases were ranked in NYHA function class I , 14 cases in class II and 5 cases in class III.Results One patient died in hospi-tal.No postoperative complications ( low cardiac output , severe arrhythmia and reoperation for hemostasis following open-heart surgery)occurred in the others.Follow-ups showed that 20 patients successfully recovered,with heart function improving to classes I-II.Conclusion Bentall procedure should be the optimal option for ascending aortic root aneurysm .Furthermore,to improve surgical technique ,reduce CPB time , decrease myocardial injury and ensure coronary artery blood flow are the essen-tial factors for surgical success .%目的：总结Bentall手术治疗主动脉根部瘤的临床经验。方法采用Bentall手术治疗主动脉根部瘤21例，其中主动脉瓣中-重度关闭不全伴主动脉根部瘤样扩张14例，主动脉瓣中-重度狭窄伴主动脉根部瘤样扩张1例，马凡综合征3例，DeBakeyII型主动脉夹层3例。术前心功能分级（ NYHA） I级2例，II级14例，III级5例。结果全组死亡1例，其余无术后并发症（低心排综合征、严重心律失常、二次开胸止血）。术后随访20例恢复良好，心功能I～Ⅱ级。结论 Bentall手术是治疗主动脉根部瘤的首选方法。改善吻合技术、缩短体外循环及深低温停循环时间、保证移植后冠状动脉通畅是提高手术成功率的关键因素。