Nakaya M, Kawazoe K, Ohara K, Kosakai Y, Sasago K, Adachi M, Ando T, Takeuchi S, Kito Y, Nakajima N
Division of Cardiovascular Surgery, National Cardiovascular Center.
Kyobu Geka. 1991 Jul;44(8 Suppl):682-6.
Replacement of the ascending aorta and the aortic valve with composite graft, including reimplantation of coronary ostia, were performed in 84 patients from October, 1978 to December, 1989. Annuloaortic ectasia was the most common indication for surgery (76 patients). Thirty patients (36%) had the Marfan syndrome. Thirty-five patients were performed with original Bentall's procedure. Thirty patients were carried out with our modified technique like Inberg's, the coronary arteries were excised with attachment of the selected piece of the aortic wall, and implanted to the tube prosthesis with continuous suture. Nineteen patients were operated with modified technique by Cabrol or other interposition graft method. The actuarial free of death related to the operation of 4 years was 83%, 88%, and 74% (p = NS) in each methods respectively. The complications of anastomosis, for example, leakage and dilatation of coronary ostia were not seen in our modified Bentall's procedure. In conclusion, our modified method is proved to be reliable and competent.
1978年10月至1989年12月期间，84例患者接受了升主动脉和主动脉瓣复合移植置换术，包括冠状动脉开口再植术。主动脉瓣环扩张是最常见的手术指征（76例患者）。30例患者（36%）患有马凡综合征。35例患者采用原始的Bentall手术。30例患者采用我们改良的类似Inberg的技术，将冠状动脉连同所选的主动脉壁一并切除，然后用连续缝合的方式植入人工血管。19例患者采用Cabrol改良技术或其他血管间置移植方法进行手术。每种方法术后4年与手术相关的无死亡生存率分别为83%、88%和74%（p=无显著性差异）。在我们改良的Bentall手术中未出现吻合口并发症，如冠状动脉开口渗漏和扩张。总之，我们改良的方法被证明是可靠且有效的。
