Kawachi Y, Tokunaga K
Department of Cardiovascular Surgery, Kyushu University School of Medicine.
Kyobu Geka. 1991 Jul;44(8 Suppl):706-11.
From 1974 to March 1991, 34 patients were operated on for ascending aortic aneurysm with aortic regurgitation caused by annuloaortic ectasia (18), dissecting aneurysm (11) and so on. Twenty-one patients underwent composite valve graft replacement, 7 separate valve graft replacement, 5 aortic resuspension and graft replacement, and one aortorrhaphy and aortic valve replacement. Four of these patients required ascending aorta and arch reconstruction. Another two patients who had previous separate valve graft replacement for annulaortic ectasia and required reoperation underwent Bentall operation successfully. The 30-day survival rate was 94%. Recently, we adopted open-unwrapping and aortic button technique. As a result we achieved no homologous blood transfusion by using "Cell Saver" and autologous blood preoperative storage program in four out of five patients of Bentall operation. Late survival rate including operative death were 78% and 63% at 5 and 10 years after operation, respectively.
1974年至1991年3月，34例患者因瓣环主动脉扩张（18例）、夹层动脉瘤（11例）等原因，接受了升主动脉瘤合并主动脉瓣关闭不全的手术治疗。21例患者接受了复合瓣膜移植置换术，7例接受了单独瓣膜移植置换术，5例接受了主动脉再悬吊和移植置换术，1例接受了主动脉修补术和主动脉瓣置换术。其中4例患者需要进行升主动脉和主动脉弓重建。另外2例曾因瓣环主动脉扩张接受单独瓣膜移植置换术且需要再次手术的患者成功接受了Bentall手术。30天生存率为94%。最近，我们采用了开放展开和主动脉纽扣技术。结果，在5例Bentall手术患者中，有4例通过使用“细胞回收器”和术前自体血储存计划实现了无同源输血。包括手术死亡在内的术后5年和10年的晚期生存率分别为78%和63%。
