Bentall手术治疗主动脉根部瘤临床分析  

Clinical Analysis of Bentall Procedure Using for Aortic Root Aneurysm

作　　者：梁志强[1] 王平凡[1] 王涛[1] 何发明[1] 张力[1] 

机构地区：[1]河南省胸科医院心血管外科,郑州市450008

出　　处：《医药论坛杂志》2007年第9期5-7,共3页Journal of Medical Forum

摘　　要：目的总结Bentall手术治疗主动脉根部瘤的临床经验。方法2001年10月-2006年12月,采用Bentall手术治疗主动脉根部瘤36例,年龄16-67岁,平均(34.5±9.7)岁。其中马方综合征24例,主动脉瓣重度狭窄致升主动脉瘤样扩张2例,大动脉炎3例,特发性升主动脉扩张7例。术前心功能分级(NYHA)Ⅱ级12例,Ⅲ级21例,Ⅳ级3例。同期行二尖瓣成形6例,三尖瓣成形2例,冠脉搭桥2例,胸骨翻转1例,肺大疱结扎1例。结果全组无手术死亡。主要术后并发症包括低心排综合征4例,严重心律失常5例,二次开胸止血1例,刀口愈合不良2例,肺部感染气管切开1例。术后随访33例。2例大动脉炎患者晚期出现瓣周漏,1例死亡。其余31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。改进缝合技术,减少心肌缺血和体外循环时间是提高手术成功率的关键因素。Objective To summarize the experience of Bentall operation using for aortic root aneurym. Methods From October 2001 to December 2006,36 patients with asending aortic root aneurysm underwent Bentall operation, aged from 16 to 67 years （34.5 ±9, 7 ）years, 24 cases were Marfan Syndrome, and 2 cases were related to aortic valve stenosis, 3 Takayasu＇s arteritis, 7 cases were annuloaortic ectasia. Before operation, 12 cases were in NYHA function class Ⅱ,21 in class Ⅲ and 3 in class Ⅳ. Concomitant operations included mitral valve anuloplasty （6 cases）, tricuspid valve anuloplasty （2 cases） , cornary artery bypass grafting （2 cases）, and sternal turnover （ 1 case）. Results There was no operative death. The morbidity included low cardiac output （4 cases）and pulmonary complication （1 case） ,33cases were followed up ranged 1 -62 months. During the period of follow -up, 2 patients of Takayasu＇s arteritis suffered with later perivalvular leakage, one later death. The other 31 cases recovered smoothly, heart function were in class Ⅰ -Ⅱ. Conclusion Bentall procedure should be the first choice for ascending aortic root aneurysm. To improve surgical technique, reduce the CPB time ,decrease the myocardial injury are the essential factors to the surgical success.

关 键 词：主动脉根部瘤 外科治疗 BENTALL手术 

分 类 号：R732.21[医药卫生—肿瘤]