Kito H, Eishi K, Kito Y, Kawazoe K, Kawashima Y
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Cardiovasc Surg. 1994 Jun;2(3):391-4.
Leakage around the coronary ostia continues to be the major complication of composite graft replacement of the ascending aorta and aortic valve. To reinforce coronary anastomosis and reduce the operating time, a new modification of the Bentall operation was developed. This procedure involves dissecting full-thickness coronary buttons while leaving the epicardium on the aortic wall and complete wrap of the composite graft by the tailored aortic wall (Carrel patch and inclusion technique). Since March 1983, this approach has been performed in 12 patients (group A) and other Bentall-type operations in 22 (group B). Time affected by haemostasis was 28 min less in group A than in B (P = 0.23). Blood loss and blood transfusion during surgery and hospitalization were significantly lower in group A than B. Significantly less leakage occurred in group A than in B. On the basis of these short-term results, the Carrel patch and inclusion technique is considered to be an accurate time- and blood-saving procedure.
冠状动脉开口周围渗漏仍然是升主动脉和主动脉瓣复合移植物置换术的主要并发症。为了加强冠状动脉吻合并缩短手术时间，开发了一种改良的Bentall手术。该手术包括解剖全层冠状动脉纽扣，同时保留主动脉壁上的心肌外膜，并使用定制的主动脉壁（Carrel补片和包裹技术）对复合移植物进行完全包裹。自1983年3月以来，已对12例患者实施了这种方法（A组），对22例患者实施了其他Bentall式手术（B组）。A组止血所需时间比B组少28分钟（P = 0.23）。A组手术期间和住院期间的失血量和输血量明显低于B组。A组的渗漏明显少于B组。基于这些短期结果，Carrel补片和包裹技术被认为是一种准确节省时间和血液的手术方法。
