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醫(yī)學論文范文:Bentall手術治療升主動脈瘤合并主動脈瓣關閉不全的療效觀察
【摘要】 目的 總結(jié)Bentall手術治療升主動脈瘤合并主動脈瓣關閉不全的治療效果。 方法 回顧分析施行Bentall手術32例，其中合并馬凡氏綜合征16例，主動脈夾層12例(Stanford A型10例、B型1例，壁間血腫1例);術前心功能(NYHA)Ⅱ級13例、Ⅲ級12例、Ⅳ級7例。結(jié)果 32例病人中，死亡3例;術后并發(fā)癥：低心排出量綜合征3例，二次開胸止血1例，室性心律失常1例，雙下肢肌力一過性下降1例，感染性心內(nèi)膜炎1例。術后隨訪30例，時間3-80個月，除1例于術后第10個月死亡，其余29例均恢復良好，心功能在Ⅰ-Ⅱ 級。結(jié)論 Bentall手術是治療升主動脈瘤合并主動脈瓣關閉不全的有效辦法，改善吻合技術、縮短體外循環(huán)及深低溫停循環(huán)時間、保證移植后冠脈有效灌注是提高手術成功率的關鍵因素。
【關鍵詞】 升主動脈瘤; 主動脈瓣關閉不全; Bentall手術
Surgical treatment of ascending aortic aneurysm by Bentall's procedure
GUO Fei-jie, et al.(The Affiliated Hospital of Ningxia Medical University, Yinchuan 750004, China)
[Abstract] Objective To review our experience in surgical treatment of ascending aortic aneurysm with aortic valve insufficiency in 32 cases by Bentall's procedure.Methods 32 patients underwent replacement of the ascending aorta and aortic valve with composite valve vascular prosthesis and received direct implantation of the aortic graft of the coronary orifices (Bentall's procedure). The range of age was from 28 to 83 years (47±12) years. Among them, 16 were of Marfan's syndrome, 12 aortic dissection (10 cases of Stanford type A, 2 cases of Stanford type B) and 14 ascending aortic aneurysm complicating severe aortic valve insufficiency. Before operation, 17 cases were in NYHA function class Ⅱ, 10 in class Ⅲ and 5 in class Ⅳ. Concomitant procedures included Bentall and hemiarch grafting in 3 cases, Bentall and mitral valve replacement in 1 case, Bentall and ligation patent ductus arteriosus in 1 case, Bentall and CABG in 1 case.Results There were 2 cases in-hospital deaths, and 1 case death in the follow-up period. Postoperative complication included low cardiac output syndrome in 1 case, reoperation for bleeding in 1 case, arrhythmia in 1 case, central neural system complication in 1 case, endocarditis 1 case, incision infection in 1 case. Postoperative 30 cases were followed up, ranged 3～80 months, all of them recovered smoothly, heart function were in class Ⅰ～Ⅱ.Conclusion Bentall's procedure can be effective in the treatment of ascending aortic aneurysm with aortic valve insufficiency. To improve surgical technique, reduce the CPB time, decreases the myocardial injury are the essential factors to the surgical success醫(yī).學全.在.線網(wǎng)站zxtf.net.cn.
[Key words] Aortic aneurysm; Bentall's procedure; Aortic valve insufficiency; Composite graft
