Spetsotaki Konstantina, Shi Jingjing, Moza Ajay, Menne Matthias, Aljalloud Ali
Department of Thoracic Surgery, University Hospital Zurich, Raemistrasse, Zurich, Switzerland.
Department of Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
Braz J Cardiovasc Surg. 2025 May 30;40(3):e20240307. doi: 10.21470/1678-9741-2024-0307.
Aortic root pathologies needing full aortic root replacement are challenging entities correlated to high morbidity and mortality due to their complexity and mostly refer to high-risk patients. In this retrospective study, we report our surgical experience and clinical results of patients undergoing a Bentall procedure as primary or reoperative surgery with the application of aortic bioconduits.
Patients who underwent full aortic root replacement utilizing either BioIntegral (BI) or Medtronic Freestyle™ (FS) bioconduit in the Cardiothoracic Surgery Department of the University Hospital Aachen RWTH from January 2015 until September 2020, in an urgent or emergency setting, were analyzed and followed up until December 2023.
Twenty-six patients underwent aortic root replacement with bioconduits (N=11 with BI, N=15 with FS) in our center. Twenty-three cases were of infective cause, and three were of noninfective cause; 30.76% were urgent, and 69.23% were emergency cases. Two (7.70%) patients died during operation due to irreversible aortic root damage. In-hospital and 30-day mortality rates were four out 26 (15.4%) patients. The mean follow-up time for all the patients was 52.01 ± 39.41 months. Patients who received a primary aortic root replacement had significantly higher survival than redo cases. BI surgery needed longer cardiopulmonary bypass times.
Clinical outcome was equal for both bioconduits. Further studies with larger cohorts are needed for deeper insights into this complex entity.
需要进行全主动脉根部置换的主动脉根部病变是具有挑战性的疾病，因其复杂性而与高发病率和死亡率相关，且大多涉及高危患者。在这项回顾性研究中，我们报告了应用主动脉生物管道进行首次或再次手术的Bentall手术患者的手术经验和临床结果。
对2015年1月至2020年9月在亚琛大学医院心胸外科因紧急或急诊情况使用BioIntegral（BI）或美敦力Freestyle™（FS）生物管道进行全主动脉根部置换的患者进行分析，并随访至2023年12月。
我们中心有26例患者使用生物管道进行了主动脉根部置换（11例使用BI，15例使用FS）。23例为感染性病因，3例为非感染性病因；30.76%为紧急情况，69.23%为急诊病例。2例（7.70%）患者因不可逆的主动脉根部损伤在手术中死亡。26例患者中有4例（15.4%）在住院期间和30天内死亡。所有患者的平均随访时间为52.01±39.41个月。接受首次主动脉根部置换的患者生存率明显高于再次手术病例。BI手术需要更长的体外循环时间。
两种生物管道的临床结果相当。需要对更大队列进行进一步研究，以更深入地了解这一复杂疾病。
