DavidⅠ与Bentall术治疗主动脉根部病变  

DavidⅠversus Bentall in aortic root disease

作　　者：周子凡[1] 王龙飞[1] 王珺[1] 刘宁宁[1] 朱俊明[1] 孙立忠[1] Zhou Zifan;Wang Longfei;Wang Jun;Liu Ningning;Zhu Junming;Sun Lizhong(Cardiac Surgery, Beijing Anzhen Hospital Affiliated Capital Medical University, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,100029

出　　处：《中华胸心血管外科杂志》2019年第7期414-416,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家科技支撑计划项目(2015BAI12B03).

摘　　要：目的比较主动脉根部病变治疗中DavidⅠ术(保留主动脉瓣的主动脉根部再植)与Bentall术(主动脉根部复合替换)的近期疗效。方法回顾分析2017年4月至2018年4月本中心采用DavidⅠ术与Bentall术治疗主动脉根部病变患者临床资料,20例行David Ⅰ术,男15例,女5例;年龄(39.6±15.8)岁;主动脉根部直径(58.3±4.4)mm。26例行Bentall术,男22例,女4例,年龄(50.8±12.6)岁,主动脉根部直径(59.5±5.0)mm。比较两组患者围手术期相关指标,术后近期心功能恢复情况。结果全部患者无死亡,术后并发症发生率组间无显著性差异。主动脉阻断时间分别为(129.5±28.6)min与(94.3±35.3)min(P<0.05),输血量(342.0±476.4)ml与(330.8±651.3)ml(P>0.05),ICU治疗时间(1.0±0.2)天与(1.1±0.3)天(P> 0.05)。至今随访(10.5±6.8)个月,David Ⅰ患者主动脉瓣反流程度未见加重(0.75±0.44对1.0±1.3,P>0.05)。结论David Ⅰ术中主动脉阻断时间较Bentall术延长,但围手术期及早期疗效良好,中远期疗效有待进一步随访。Objective To evaluate the safety and efficiency in aortic root disease. Methods From April 2017 to April 2018, 46 cases of aortic root disease accepted DavidⅠ[20 cases, 15 males and 5 females, aged(39.6±15.8)years, aortic root diameter was(58.3±4.4)mm] or Bentall[26 cases, 22 males and 4 females, aged(50.8±12.6)years, aortic root diameter was(59.5±5.0)mm], the data in the peri-operation and heart function in recent period after operation. Results No mortality was observed in the study. Morbidity occurred in both group was comparable. Mean cross-clamp time(129.5±28.6)min vs.(94.3±35.3)min(P<0.05). Blood transfusion(342.0±476.4)ml vs.(330.8±651.3)ml(P>0.05). ICU staying time(1.0±0.2)day vs.(1.1±0.3)day(P>0.05). At the latest visit(10.5±6.8)months in David Ⅰ, no obviously regurgitation of aortic valve were observed 0.75±0.44 vs 1.0±1.3(P>0.05). Conclusion Except for the prolonged cross-clamp time, David Ⅰ is safely and effective in aortic root disease compared with Bentall in peri-operative period . The long term results need further follow-up .

关 键 词：主动脉根部重建 保留主动脉瓣的主动脉根部再植 主动脉根部复合替换 

分 类 号：R654.3[医药卫生—外科学]