Katoh T, Esato K, Mikamo A, Suzuki K, Gohra H, Hamano K, Fujimura Y, Tsuboi H
First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Surg Today. 1997;27(4):373-5. doi: 10.1007/BF00941817.
The successful implementation of a reoperative Bentall procedure with concomitant total aortic arch replacement after ascending aortic replacement for acute aortic dissection is infrequently reported. We performed a modified Bentall procedure with total replacement of the aortic arch in a patient suffering from worsening aortic regurgitation (AR) and residual dissection. Our strategy involved the button method for coronary reconstruction, selective cerebral perfusion, the use of a composite graft with four branches for aortic arch replacement, and the administration of high-dose aprotinin to decrease bleeding.
急性主动脉夹层升主动脉置换术后再次行Bentall手术并同期全主动脉弓置换术成功实施的报道较少。我们对一名主动脉瓣反流（AR）加重且存在残余夹层的患者实施了改良Bentall手术并全主动脉弓置换。我们的策略包括采用纽扣法进行冠状动脉重建、选择性脑灌注、使用带四分支的复合移植物进行主动脉弓置换，以及给予大剂量抑肽酶以减少出血。
