Iida Yasunori, Ichinokawa Takahisa, Kuroo Kento, Inaba Yu, Hachiya Takashi, Shimizu Hideyuki
Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
Kyobu Geka. 2024 Jul;77(7):491-495.
This study aimed to review the results of the bio-Bentall procedure in patients over 65 years of age at our hospital.
Of the 65 aortic root replacement procedures performed at our hospital from October 2015 to January 2024, we reviewed 45 bio-Bentall procedures performed on patients 65 years of age or older. These patients consisted of 39 men and 6 women, with a mean age of 72 years. There were 5 patients with aortic dissection and 40 patients with non-dissection, and 6 patients had reoperation. There were 19 concomitant surgeries, including coronary artery bypass grafting, valve surgery, and aortic procedure. The bioprosthetic valves used were Magna EASE in 17 patients, Inspiris in 25 patients, Trifecta in 2 patients, and Avalus in 1 patient. All Valsalva grafts used were J Graft Valsalva.
The mean intubation time was 19 hours, and the mean intensive care unit( ICU) stay was 6 days. The number of in-hospital deaths was 3 patients, and the mean length of hospital stay was 18 days. The remote mortality rate was 4( 1 heart failure, 2 lung cancer, and 1 pancreatic cancer). There have been no case of reoperation, structural valve deterioration (SVD), or thromboembolism to date, and the rates of freedom of reoperation, SVD, and thromboembolism were all 100%. The 1-, 3-, 5-, and 7-year survival rates were 91.1%, 86.4%, 83.6%, and 83.6%, respectively.
The surgical and long-term outcomes of the bio-Bentall procedure in patients over 65 years of age were stable. In patients who may outlive the bioprosthetic valve life, it is important to perform an appropriate and durable Bentall procedure, including valve-in-valve, prioritizing the future of each patient.
本研究旨在回顾我院65岁以上患者生物Bentall手术的结果。
在2015年10月至2024年1月于我院进行的65例主动脉根部置换手术中，我们回顾了对65岁及以上患者进行的45例生物Bentall手术。这些患者包括39名男性和6名女性，平均年龄为72岁。有5例主动脉夹层患者和40例非夹层患者，6例患者进行了再次手术。有19例同期手术，包括冠状动脉搭桥术、瓣膜手术和主动脉手术。使用的生物人工瓣膜中，17例患者使用Magna EASE，25例患者使用Inspiris，2例患者使用Trifecta，1例患者使用Avalus。所有主动脉窦移植物均使用J型主动脉窦移植物。
平均插管时间为19小时，平均重症监护病房（ICU）住院时间为6天。住院死亡人数为3例，平均住院时间为18天。远期死亡率为4例（1例心力衰竭、2例肺癌和1例胰腺癌）。迄今为止，尚无再次手术、结构性瓣膜退变（SVD）或血栓栓塞病例，再次手术、SVD和血栓栓塞的无事件发生率均为100%。1年、3年、5年和7年生存率分别为91.1%、86.4%、83.6%和83.6%。
65岁以上患者生物Bentall手术的手术和长期结果稳定。对于可能存活超过生物人工瓣膜寿命的患者，进行适当且持久的Bentall手术（包括瓣中瓣手术）非常重要，要优先考虑每位患者的未来。
