改良 Bentall 手术联合新型生物瓣血管移植物。

Modified Bentall operation with a novel biologic valved conduit.

机构信息

Division of Cardiothoracic Surgery, Columbia University, New York, New York 10032, USA.

出版信息

Ann Thorac Surg. 2010 Mar;89(3):938-41. doi: 10.1016/j.athoracsur.2009.11.043.

DOI:10.1016/j.athoracsur.2009.11.043

PMID:20172157

Abstract

PURPOSE

The optimal conduit for a modified Bentall operation remains unknown. The current study tested hemodynamics and early clinical results of the newly developed valved conduit composed of the 3f Aortic Bioprosthesis (ATS Medical, Minneapolis, MN) and the Vascutek Gelweave Valsalva Aortic Root Graft (Terumo Cardiovascular Systems, Ann Arbor, MI).

DESCRIPTION

Between December 1, 2008, and April 6, 2009, 20 patients underwent a modified Bentall operation with this valved conduit and their clinical records were retrospectively reviewed.

EVALUATION

The indication for aortic root replacement in the 20 patients was aortic root aneurysm in 14, acute type A dissection in 5, and structural deterioration of an aortic root homograft in 1. Four patients had had previous cardiac operations, and 8 patients required concomitant procedures. Mean cardiopulmonary bypass and aortic cross-clamp times were 146 +/- 110 minutes and 110 +/- 32 minutes, respectively. There were no perioperative deaths. The average mean pressure gradient across the bioprosthesis assessed with intraoperative transesophageal echocardiogram was 4.0 +/- 1.7 mm Hg.

CONCLUSIONS

Our initial experience with our new valved conduit showed favorable results. Further accumulation of cases and longer follow-up are warranted.

摘要

目的

改良 Bentall 手术的最佳移植物仍不明确。本研究检测了由 3f 主动脉生物瓣（明尼苏达州明尼阿波利斯市 ATS 医疗公司）和 Vascutek Gelweave Valsalva 主动脉根部移植物（密歇根州安阿伯市 Terumo 心血管系统公司）组成的新型带瓣移植物的血流动力学和早期临床结果。

描述

2008 年 12 月 1 日至 2009 年 4 月 6 日期间，20 例患者接受了改良 Bentall 手术，使用该带瓣移植物，并对其临床资料进行回顾性分析。

评估

20 例患者行主动脉根部置换的适应证为主动脉根部瘤 14 例，急性 A 型夹层 5 例，主动脉根部同种异体移植物结构恶化 1 例。4 例患者有既往心脏手术史，8 例患者需要同时进行其他手术。体外循环和主动脉阻断时间分别为 146±110 分钟和 110±32 分钟。无围手术期死亡。术中经食管超声心动图评估的生物瓣平均跨瓣压力梯度为 4.0±1.7mmHg。