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[改良Bentall手术治疗主动脉根部瘤的经验]

[Experience of modified Bentall's procedure for annulo-aortic ectasia].

作者信息

Hayase S, Yano Y, Ogawa K, Fujita K, Yuasa T, Kidokoro H, Hattori T

机构信息

Department of Thoracic Surgery, Japanese Red Cross, Nagoya First Hospital.

出版信息

Kyobu Geka. 1995 Feb;48(2):87-91; discussion 92-4.

PMID:7897892
Abstract

To reduce the incidence of false aneurysm formation at the suture lines, a known complication with the inclusion technique such as Bentall's procedure or Cabrol's procedure, modified Bentall's procedure (Carrel patch technique), which is identical to Inberg's procedure, has been selected as treatment for annulo-aortic ectasia since 1991. This operation was carried out in 6 consecutive patients with annulo-aortic ectasia from July 1991 to August 1992. The aortic valve and the aneurysm were resected, the coronary ostia were dissected free, mobilized, and then implanted to the composite graft. It was necessary for one patient to undergo coronary artery bypass grafting for myocardial ischemia due to injury of the right coronary ostium. Thereafter, the button of coronary ostium was cut into a big size and then trimmed just before the implantation to the composite graft in order to prevent injury of the button of the coronary ostium. There was no hospital mortality. No pseudo-aneurysm at the coronary ostia or the distal aortic anastomosis was observed at control aortography carried out 1 month after surgery. One patient died 1 year after the first operation because of low cardiac output after the re-operation for pseudo-aneurysm at the proximal aortic anastomosis and infection of the composite graft. All the other patients have been symptom free during follow-up. The use of gelatin impregnated dacron graft and the reinforcement of the suture lines by Teflon felt strips minimized bleeding. One patient underwent this operation without blood transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为降低缝合线处假性动脉瘤形成的发生率(这是诸如Bentall手术或Cabrol手术等包含技术的一种已知并发症),自1991年起,已选择与Inberg手术相同的改良Bentall手术(Carrel补片技术)来治疗主动脉瓣环扩张症。1991年7月至1992年8月,对6例连续性主动脉瓣环扩张症患者实施了该手术。切除主动脉瓣和动脉瘤,游离、松解冠状动脉开口,然后将其植入复合移植物。有1例患者因右冠状动脉开口损伤导致心肌缺血而接受了冠状动脉旁路移植术。此后,将冠状动脉开口纽扣剪成较大尺寸,在植入复合移植物前进行修剪,以防止冠状动脉开口纽扣受损。无医院死亡病例。术后1个月进行的主动脉造影检查未发现冠状动脉开口或远端主动脉吻合处有假性动脉瘤。1例患者在首次手术后1年因近端主动脉吻合处假性动脉瘤再次手术及复合移植物感染后出现低心排血量而死亡。所有其他患者在随访期间均无症状。使用明胶浸渍的涤纶移植物以及用特氟龙毡条加固缝合线可使出血减至最少。1例患者接受该手术未输血。(摘要截选至250字)

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