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[升主动脉及主动脉瓣全置换术的手术结果——Bentall手术与Cabrol手术的特征性差异]

[Operative results of total replacement of the ascending aorta and aortic valve--characteristic difference between Bentall's and Cabrol's procedures].

作者信息

Miyahara K, Kawase M, Mannouji E, Abe T

机构信息

Division of Surgery, Sakakibara Heart Institute, Tokyo, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1994 Mar;42(3):371-8.

PMID:8176294
Abstract

From May 1979 to November 1991, 26 patients underwent total replacement of the ascending aorta and aortic valve. We employed 15 Bentall's procedure (group B) and 11 Cabrol's procedure (group C). There were no significant difference in age and etiology between the two groups. Inclusion technique was used in all patients. Compared group B with group C, both the operation time and the aortic cross-clamp time were significantly shorter in group C than in group B. (p < 0.05, p < 0.01 respectively). There were no operative death in group B and one in group C. There were two death in group B in later postoperative period. One was due to the anastomotic leakage at the distal site with infection, and the other was cardiac death caused by the infectious fistula between wrapping cavity and RA. The postoperative actuarial survival rate for group B at 12.8 years was 86.7% and that for group C at 5.1 years was 90.9%. The late complications such as coronary-graft anastmotic leakage or pseudoaneurysm, hematoma between the wrap and the graft and anastomotic leakage at the distal site were recognized more in group B. In group C no pseudoaneurysm were noted, but hematoma was noted in two patients. The rate of complications in late phase was significantly lower in group B (p < 0.05). Although as a procedure of total replacement of the ascending aorta and aortic valve both Bentall's and Cabrol's procedure represent satisfactory operative results, Cabrol's procedure has some advantages and fewer postoperative complications.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1979年5月至1991年11月,26例患者接受了升主动脉和主动脉瓣全置换术。我们采用了15例Bentall手术(B组)和11例Cabrol手术(C组)。两组患者在年龄和病因方面无显著差异。所有患者均采用包埋技术。B组与C组相比,C组的手术时间和主动脉阻断时间均明显短于B组(分别为p<0.05,p<0.01)。B组无手术死亡,C组有1例手术死亡。B组术后晚期有2例死亡。1例死于远端吻合口漏合并感染,另1例死于心包腔与右心房之间的感染性瘘导致的心源性死亡。B组12.8年的术后精算生存率为86.7%,C组5.1年的术后精算生存率为90.9%。B组晚期并发症如冠状动脉移植吻合口漏或假性动脉瘤、心包与移植血管间血肿及远端吻合口漏等更为常见。C组未发现假性动脉瘤,但有2例患者出现血肿。B组晚期并发症发生率显著低于C组(p<0.05)。虽然作为升主动脉和主动脉瓣全置换术,Bentall手术和Cabrol手术均取得了满意的手术效果,但Cabrol手术具有一些优势且术后并发症较少。(摘要截取自250字)

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