• 沈陽軍區(qū)總醫(yī)院 心血管外科,沈陽 110016;

目的 評價Bentall手術(shù)治療馬方綜合征(Marfan syndrome)的近、遠期療效?!》椒ā』仡櫺苑治錾蜿栜妳^(qū)總醫(yī)院1998年3月至2011年2月連續(xù)收治的65例馬方綜合征患者的臨床資料,其中男41例,女24例;年齡8~62(42.1±13.3)歲。合并主動脈夾層動脈瘤De BakeyⅠ型14例,Ⅱ型2例;重度主動脈瓣關(guān)閉不全42例,中度二尖瓣關(guān)閉不全7例,中度三尖瓣關(guān)閉不全4例。行經(jīng)典法Bentall手術(shù)29例,紐扣法Bentall手術(shù)36例;同期行其它復雜手術(shù)18例。術(shù)后隨訪2~163個月, 分析Bentall手術(shù)治療馬方綜合征近、遠期療效,同時比較行經(jīng)典法與紐扣法Bentall手術(shù)患者的生存率?!〗Y(jié)果 手術(shù)時間215~675 (359.0±104.0) min,體外循環(huán)時間103~318 (157.0±41.0) min,主動脈阻斷時間60~159 (94.0±25.0) min,深低溫停循環(huán)時間13~35 (23.0±7.0) min。術(shù)后住重癥監(jiān)護室時間1~21 (5.4±3.5) d,機械通氣輔助時間1~11 (2.3±2.2) d,住院時間8~59 (28.1±10.6) d。住院死亡4例(6.1%),術(shù)后早期并發(fā)癥25例(38.5%)。隨訪期間死亡12例(19.7%),遠期并發(fā)癥11例(18.0%)。所有痊愈出院患者1年、3年、5年和10年生存率分別為96.5%±2.5%、86.1%±4.9%、77.5%±6.5%和69.7%±7.9%,生存(10.6±0.7)年,95% CI (9.1,12.0)。行紐扣法Bentall手術(shù)患者生存率高于經(jīng)典法Bentall手術(shù),且差異有統(tǒng)計學意義(P=0.034)。 結(jié)論 Bentall手術(shù)治療馬方綜合征安全、有效,近期及遠期結(jié)果滿意,行紐扣法Bentall手術(shù)患者生存率更高。

引用本文: 蘭懷,王輝山,韓宏光,陶登順,孟慶濤,徐莉瑩,李曉密,王宏鑫. Bentall手術(shù)治療馬方綜合征的療效分析. 中國胸心血管外科臨床雜志, 2013, 20(1): 100-102. doi: 復制

1. valve. J Heart Valve Dis, 2002, 11 (4):485-491.
2.  Bentall H, de Bono A. A technique for complete replacement of the ascending aorta. Thorax, 1968, 23 (4):338-339.
3.  Gott VL, Cameron DE, Alejo DE, et al. Aortic root replacement in 271 Marfan patients:a 24-year experience. Ann Thorac Surg, 2002, 73 (2):438-443.
4.  Prifti E, Bonacchi M, Frati G, et al. Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique. Eur J Cardiothorac Surg, 2002, 21 (1):15-21.
5.  Cohn LH, Rizzo RJ, Adams DH, et al. Reduced mortality and morbidity for ascending aortic aneurysm resection regardless of cause. Ann Thorac Surg, 1996, 62 (2):463-468.
6.  Houël R, Soustelle C, Kirsch M, et al. Long-term results of the Bentall operation versus separate replacement of the ascending aorta and aortic.
7.  Asano KI, Ando T, Hanada S, et al. Control of bleeding during the Bentall operation. J Cardiovasc Surg (Torino), 1983, 24 (1):13-14.
8.  Cabrol C, Pavie A, Mesnildrey P, et al. Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries. J Thorac Cardiovasc Surg, 1986, 91 (1):17-25.
9.  David TE, Feindel CM, Webb GD, et al. Aortic valve preservation in patients with aortic root aneurysm:results of the reimplantation technique. Ann Thorac Surg, 2007, 83 (2):S732-S735.
10.  Kerendi F, Guyton RA, Vega JD, et al. Early results of valve-sparing aortic root replacement in high-risk clinical scenarios. Ann Thorac Surg, 2010, 89 (2):471-476.
11.  Bernhardt AM, Treede H, Rybczynski M, et al. Comparison of aortic root replacement in patients with Marfan syndrome. Eur J Cardiothorac Surg, 2011, 40 (5):1052-1057.
12.  Etz CD, Homann TM, Silovitz D, et al. Long-term survival after the Bentall procedure in 206 patients with bicuspid aortic valve. Ann Thorac Surg, 2007, 84 (4):1186-1193.
13.  Urbanski PP, Heinz N, Zhan X, et al. Modified bio-Bentall procedure:10-year experience. Eur J Cardiothorac Surg, 2010, 37 (6):1317-1321.
14.  Westaby S, Katsumata T, Vaccari G. Aortic root replacement with coronary button re-implantation:low risk and predictable outcome. Eur J Cardiothorac Surg, 2000, 17 (3):259-265.
15.  Ehrlich MP, Ergin MA, Mccullough JN, et al. Predictors of adverse outcome and transient neurological dysfunction after ascending aorta/hemiarch replacement. Ann Thorac Surg, 2000, 69 (6):1755-1763.
16.  Cameron DE, Alejo DE, Patel ND, et al. Aortic root replacement in 372 Marfan patients:evolution of operative repair over 30 years. Ann Thorac Surg, 2009, 87 (5):1344-1349.
  1. 1. valve. J Heart Valve Dis, 2002, 11 (4):485-491.
  2. 2.  Bentall H, de Bono A. A technique for complete replacement of the ascending aorta. Thorax, 1968, 23 (4):338-339.
  3. 3.  Gott VL, Cameron DE, Alejo DE, et al. Aortic root replacement in 271 Marfan patients:a 24-year experience. Ann Thorac Surg, 2002, 73 (2):438-443.
  4. 4.  Prifti E, Bonacchi M, Frati G, et al. Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique. Eur J Cardiothorac Surg, 2002, 21 (1):15-21.
  5. 5.  Cohn LH, Rizzo RJ, Adams DH, et al. Reduced mortality and morbidity for ascending aortic aneurysm resection regardless of cause. Ann Thorac Surg, 1996, 62 (2):463-468.
  6. 6.  Houël R, Soustelle C, Kirsch M, et al. Long-term results of the Bentall operation versus separate replacement of the ascending aorta and aortic.
  7. 7.  Asano KI, Ando T, Hanada S, et al. Control of bleeding during the Bentall operation. J Cardiovasc Surg (Torino), 1983, 24 (1):13-14.
  8. 8.  Cabrol C, Pavie A, Mesnildrey P, et al. Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries. J Thorac Cardiovasc Surg, 1986, 91 (1):17-25.
  9. 9.  David TE, Feindel CM, Webb GD, et al. Aortic valve preservation in patients with aortic root aneurysm:results of the reimplantation technique. Ann Thorac Surg, 2007, 83 (2):S732-S735.
  10. 10.  Kerendi F, Guyton RA, Vega JD, et al. Early results of valve-sparing aortic root replacement in high-risk clinical scenarios. Ann Thorac Surg, 2010, 89 (2):471-476.
  11. 11.  Bernhardt AM, Treede H, Rybczynski M, et al. Comparison of aortic root replacement in patients with Marfan syndrome. Eur J Cardiothorac Surg, 2011, 40 (5):1052-1057.
  12. 12.  Etz CD, Homann TM, Silovitz D, et al. Long-term survival after the Bentall procedure in 206 patients with bicuspid aortic valve. Ann Thorac Surg, 2007, 84 (4):1186-1193.
  13. 13.  Urbanski PP, Heinz N, Zhan X, et al. Modified bio-Bentall procedure:10-year experience. Eur J Cardiothorac Surg, 2010, 37 (6):1317-1321.
  14. 14.  Westaby S, Katsumata T, Vaccari G. Aortic root replacement with coronary button re-implantation:low risk and predictable outcome. Eur J Cardiothorac Surg, 2000, 17 (3):259-265.
  15. 15.  Ehrlich MP, Ergin MA, Mccullough JN, et al. Predictors of adverse outcome and transient neurological dysfunction after ascending aorta/hemiarch replacement. Ann Thorac Surg, 2000, 69 (6):1755-1763.
  16. 16.  Cameron DE, Alejo DE, Patel ND, et al. Aortic root replacement in 372 Marfan patients:evolution of operative repair over 30 years. Ann Thorac Surg, 2009, 87 (5):1344-1349.