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作为一种挽救生命手术的Bentall手术:单中心经验

Bentall procedure as a lifesaving surgery: A single center experience.

作者信息

Al-Mudhaffar Saif S, Alwan Ala, Ouj Rafid, Mowaffaq Abdullah, Kakamad Fahmi H, Ahmad Okba F, Mohammed-Saeed Dana H, Ali Razhan K, Abdalla Berun A, Mohammed Shvan H, Salih Abdulwahid M

机构信息

Department of Cardiac Surgery, Ibn Al-Bitar Specialized Center for Cardiac Surgery, Baghdad 10011, Iraq.

College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq.

出版信息

Med Int (Lond). 2023 Jan 10;3(1):8. doi: 10.3892/mi.2023.68. eCollection 2023 Jan-Feb.

Abstract

The Bentall procedure is a surgical technique used in the management of aortic root abnormalities with ascending aorta and aortic valve issues. The present study aimed to evaluate the outcomes of 18 patients treated with the Bentall procedure in a single center. The present study was a single-center retrospective case series conducted over a period of 3 years. The patients had either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction. The Bentall procedure was performed via standard median sternotomy. St. Jude Medical composite grafts with a valve were applied in all cases. A total number of 18 patients with either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction were included in the study. The age of the participants ranged from 27-60 years. The ratio of males to females was 16:2 (males, 88.8%). The symptoms developed 3-4 days prior to hospital admission. Chest pain was the most common presenting symptom (n=10, 55.5%). Hypertension was the most common risk factor (n=12, 66.6%). In total, 14 cases underwent emergency surgery (77.7%). The emergency surgery was performed in 9 patients within 24 h of arrival owing to the association of aortic root dissection with tamponade. For the other cases, the surgery was performed within 2 and 7 days (n=5, 27.7% and n=4, 22.2%) respectively. Early post-operative complications occurred in 5 patients (27.7%). On the whole, as demonstrated herein, the modifications of the Bentall procedure have a notable impact on decreasing the overall mortality rates. Raising the awareness of clinicians and the general population as regards aortic dissection may aid in the early referral of patients to specialized centers and may thus decrease the overall mortality rate.

摘要

Bentall手术是一种用于治疗伴有升主动脉和主动脉瓣问题的主动脉根部异常的外科技术。本研究旨在评估在单一中心接受Bentall手术治疗的18例患者的治疗结果。本研究是一项在3年期间进行的单中心回顾性病例系列研究。患者患有急性升主动脉夹层和/或伴有主动脉瓣功能障碍的升主动脉扩张。Bentall手术通过标准正中胸骨切开术进行。所有病例均应用带瓣膜的圣犹达医疗复合移植物。本研究共纳入18例患有急性升主动脉夹层和/或伴有主动脉瓣功能障碍的升主动脉扩张的患者。参与者的年龄在27至60岁之间。男女比例为16:2(男性,88.8%)。症状在入院前3至4天出现。胸痛是最常见的首发症状(n = 10,55.5%)。高血压是最常见的危险因素(n = 12,66.6%)。总共14例患者接受了急诊手术(77.7%)。由于主动脉根部夹层合并心包填塞,9例患者在到达后24小时内进行了急诊手术。对于其他病例,手术分别在2天和7天内进行(n = 5,27.7%和n = 4,22.2%)。5例患者(27.7%)发生早期术后并发症。总体而言,如本文所示,Bentall手术的改良对降低总体死亡率有显著影响。提高临床医生和普通人群对主动脉夹层的认识可能有助于患者早期转诊至专科中心,从而降低总体死亡率。

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本文引用的文献

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Bentall Procedure: A Systematic Review and Meta-Analysis.Bentall手术:一项系统评价与荟萃分析。
Ann Thorac Surg. 2016 May;101(5):1684-9. doi: 10.1016/j.athoracsur.2015.10.090. Epub 2016 Feb 6.
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J Thorac Cardiovasc Surg. 2010 Dec;140(6 Suppl):S64-70; discussion S86-91. doi: 10.1016/j.jtcvs.2010.07.033.
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Surgery for aneurysms of the aortic root: a 30-year experience.主动脉根部动脉瘤的手术治疗:30年经验
Circulation. 2004 Sep 14;110(11):1364-71. doi: 10.1161/01.CIR.0000141593.05085.87. Epub 2004 Aug 16.

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