Department of Cardiovascular Surgery, Fukushima Medical University.
Department of Cardiovascular Surgery, Yonezawa City Hospital.
Fukushima J Med Sci. 2021 Dec 21;67(3):119-127. doi: 10.5387/fms.2021-06. Epub 2021 Nov 6.
To evaluate the early and late outcomes of the modified Bentall procedure with the flanged technique.
We reviewed the medical records of 63 patients who had undergone root replacement by the modified Bentall procedure at our institute between January 2001 and December 2018. In most cases, we adopted a composite graft constructed with a mechanical valve or bioprosthesis and a Dacron graft by the flanged technique. Since 2011, we have used Valsalva grafts.
Mean age 57 ± 16 years, range 16-80, male 43 cases. The mean follow-up was 75 ± 56 months (range 0-216). Through April 1, 2020, we could follow up on 61 cases (97%) within a six-month period. Hospital mortality was 7.9% (4.8% in elective cases). In late follow-up, eight deaths were observed. In the bio-Bentall group (n=26), no deaths or major adverse valve-related events (MARVEs) occurred. In the mechanical Bentall group (n=37), seven cases of MARVEs, including two cerebral hemorrhages and one cerebral embolism, were observed. All patients were free from MARVEs at 5 years post procedure in the bio-Bentall group, and 93.8% and 76.8% were event-free at 5 years and 10 years, respectively, in the mechanical Bentall group.
The 18-year results of the modified Bentall procedure were acceptable, providing excellent outcomes in the bio-Bentall group. The flanged technique enabled the use of a larger prosthesis, which may have resulted in good durability with the bio-Bentall procedure.
评估改良 Bentall 手术加翻边技术的早期和晚期结果。
我们回顾了 2001 年 1 月至 2018 年 12 月期间在我院接受改良 Bentall 手术根部置换的 63 例患者的病历。在大多数情况下，我们采用复合移植物，由机械瓣膜或生物假体和翻边技术的 Dacron 移植物组成。自 2011 年以来，我们使用了 Valsalva 移植物。
平均年龄 57±16 岁，范围 16-80 岁，男性 43 例。平均随访时间为 75±56 个月（范围 0-216）。截至 2020 年 4 月 1 日，我们可以在 6 个月内对 61 例患者（97%）进行随访。住院死亡率为 7.9%（择期病例为 4.8%）。在晚期随访中，观察到 8 例死亡。在生物 Bentall 组（n=26）中，无死亡或主要不良瓣膜相关事件（MARVE）发生。在机械 Bentall 组（n=37）中，观察到 7 例 MARVE，包括 2 例脑出血和 1 例脑栓塞。生物 Bentall 组所有患者术后 5 年无 MARVE，机械 Bentall 组分别有 93.8%和 76.8%的患者在术后 5 年和 10 年无事件。
改良 Bentall 手术 18 年的结果是可以接受的，生物 Bentall 组提供了优异的结果。翻边技术可以使用更大的假体，这可能导致生物 Bentall 手术具有良好的耐久性。
