Redo-Bentall surgery for aortic root lesions: a report of case series

Xiaobo PENG; Fan LI; Tianbo LI; Chencheng LIU; Bo XU; Han XIA; Yingbin XIAO; Yong WANG

doi:10.16016/j.2097-0927.202304019

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Redo-Bentall surgery for aortic root lesions: a report of case series

Clinical Medicine | 更新时间：2026-01-09

- Redo-Bentall surgery for aortic root lesions: a report of case series
- Journal of Army Medical University Vol. 46, Issue 10, Pages: 1158-1163(2024)
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院全军心血管外科研究所
- 作者简介：
- 基金信息：
  
  the General Project of Natural Science Foundation of Chongqing(CSTB2022NSCQ-MSX0200);the Clinical Technology Innovation Cultivation Project of Army Medical University(CX2019JS216)
- DOI：10.16016/j.2097-0927.202304019
  CLC： R543.106;R615;R654.2
- Received：05 April 2023，
  
  Revised：2023-10-22，
  
  Published：30 May 2024
- 稿件说明：
移动端阅览
Xiaobo PENG, Fan LI, Tianbo LI, et al. Redo-Bentall surgery for aortic root lesions: a report of case series[J]. Journal of Army Medical University, 2024, 46(10): 1158-1163.
DOI：

Xiaobo PENG, Fan LI, Tianbo LI, et al. Redo-Bentall surgery for aortic root lesions: a report of case series[J]. Journal of Army Medical University, 2024, 46(10): 1158-1163. DOI： 10.16016/j.2097-0927.202304019.

摘要

目的

观察再次升主动脉带瓣管道置换(Redo-Bentall)手术在主动脉根部病变中应用的临床效果。

方法

总结2010年6月至2022年4月我科接受再次Bentall手术的主动脉根部病变患者46例，其中男性35例，女性11例，年龄(43.37±12.79)岁，距上一次手术(4.96±6.76)年，收集、分析患者围手术期、随访期间临床资料，Kaplan-meier生存分析比较各病因组生存率。

结果

本组病例中心内膜炎9例、白塞氏病12例，其余病因25例。术后出现心跳骤停4例(8.70%)、肾功能衰竭4例(8.70%)、消化道出血2例(4.35%)、新发三度房室传导阻滞并安置永久起搏器2例(4.35%)，围手术期死亡3例(6.52%)。出院后随访(5.03±3.27)年，失访5例(11.63%)，死亡1例(2.33%)，发生腔隙性脑梗死1例(2.33%)，其余无严重出血或栓塞并发症。心内膜炎组(62.3%)、白塞氏病组(70.0%)远期生存率明显低于其余病因组(80.0%)，差异具有统计学意义(

＜0.05)。

结论

再次Bentall手术在主动脉根部病变中的应用是安全有效的，其中感染性心内膜炎、白塞氏病的患者生存率相对较低。

Abstract

Objective

To observe the clinical efficacy of Redo-Bentall surgery in the reoperation of aortic root lesions.

Methods

A retrospective analysis was performed on 46 patients who underwent Redo-Bentall surgery for aortic root lesions in our department from June 2010 to April 2022. They were 35 males and 11 females

at a mean age of 43.37±12.79 years

in 4.96±6.76 years since the last operation. General clinical data in perioperative period and during follow-up were collected and analyzed. Kaplan-Meier survival analysis was used to compare the survival rates of each etiological group.

Results

There were 9 cases of central end otitis

12 cases of Behset's disease

and 25 cases of other causes. After operation

4 cases (8.70%) experienced cardiac arrest

4 cases (8.70%) renal failure

2 cases (4.35%) gastrointestinal bleeding

2 cases (4.35%) new third-degree atrioventricular block and 2 cases (4.35%) permanent pacemaker placement. In perioperative period

3 cases (6.52%) died in hospital. During a mean follow-up of 5.03±3.27 years after discharge

5 cases (11.63%) were lost to follow-up

1 case died (2.33%)

1 case had lacunar infarction (2.33%)

and no severe bleeding

or embolism complications was observed in the rest patients. The long-term survival rate was significantly lower in the endocarditis group (62.3%) and the Behcet's disease group (70%) than the other etiological groups (80%

0.05).

Conclusion

The application of Redo-Bentall in the reoperation of aortic root lesions is safe and effective

but the survival rate is quite lower in the patients with infective endocarditis and Behcet's disease.

关键词

Keywords

references

崔金帅, 晁文晗, 高秉仁, 等. 主动脉根部疾病手术选择的研究进展[J]. 中国胸心血管外科临床杂志, 2019, 26(5): 504-508. DOI: 10.7507/1007-4848.201808013.

CUI J S, CHAO W H, GAO B R, et al . Progress in surgical selection of aortic root diseases[J ] . Chin J Clin Thorac Cardiovasc Surg, 2019, 26(5): 504-508. DOI: 10.7507/1007-4848.201808013.

SONG L C, HE G B, IMIN E, et al . "Chimney" bentall procedure in the small aortic root after prior aortic valve operations[J ] . Ann Thorac Surg, 2020, 110(3): e241-e243. DOI: 10.1016/j.athoracsur.2020.02.035.

VAN H D, PHAM T B, CHAU C L, et al . Modified Bentall procedure: a 15-year single-center clinical experience[J ] . Asian Cardiovasc Thorac Ann, 2022, 30(7): 779-787. DOI: 10.1177/02184923221090692.

陆杰, 薛清, 唐杨烽, 等. 心脏术后再次行主动脉根部置换的临床分析[J]. 中国胸心血管外科临床杂志, 2021, 28(1): 99-103. DOI: 10.7507/1007-4848.202003100.

LU J, XUE Q, TANG Y F, et al . Clinical analysis of redo aortic root replacement after cardiac surgery[J ] . Chin J Clin Thorac Cardiovasc Surg, 2021, 28(1): 99-103. DOI: 10.7507/1007-4848.202003100.

DENG J Y, ZHONG Q J. Clinical analysis of redo aortic root replacement after cardiac surgery: a retrospective study[J]. J Cardiothorac Surg, 2021, 16(1): 202. DOI: 10.1186/s13019-021-01587-8.

BROWN C, HAN J, SPERRY A E, et al . The impact of surgeon and hospital procedural volume on outcomes after aortic root replacement in the United States[J ] . J Card Surg, 2021, 36(8): 2669-2676. DOI: 10.1111/jocs.15620.

李高山, 潘文旭, 高智春, 等. Stanford B型主动脉夹层患者TEVAR术后发生植入后综合征的危险因素[J]. 陆军军医大学学报, 2023, 45(20): 2149-2158. DOI: 10.16016/j.2097-0927.202307091.

LI G S, PAN W X, GAO Z C, et al . Risk factors for TEVAR-related post-implantation syndrome in Stanford type B aortic dissection patients[J ] . J Army Med Univ, 2023, 45(20): 2149-2158. DOI: 10.16016/j.2097-0927.202307091.

范舒雅, 畅怡, 郭宏伟, 等. 主动脉根部袖状包裹技术在改良Bentall手术中应用的近期疗效[J]. 中华胸心血管外科杂志, 2021, 37(9): 550-552. DOI: 10.3760/cma.j.cn112434-20210524-00177.

FAN S Y, CHANG Y, GUO H W, et al . Short-term outcomes of cuff wrapping technique using remnant aortic wall in modified bentall procedure[J ] . Chin J Thorac Cardiovasc Surg, 2021, 37(9): 550-552. DOI: 10.3760/cma.j.cn112434-20210524-00177.

HARKY A, OTHMAN A, NISTAL DE PAZ C, et al . Systematic approach to diagnosis and management of infected prosthetic grafts in the proximal aorta[J ] . J Card Surg, 2021, 36(1): 145-152. DOI: 10.1111/jocs.15122.

SPONGA S, DI MAURO M, MALVINDI P G, et al . Surgery for Bentall endocarditis: short- and midterm outcomes from a multicentre registry[J ] . Eur J Cardiothorac Surg, 2020, 58(4): 839-846. DOI: 10.1093/ejcts/ezaa136.

ZOGG C K, AVESTA A, BONDE P N, et al . Echocardiography fails to detect an extensive aortic root abscess in a patient with infective endocarditis: a case report[J ] . Eur Heart J Case Rep, 2022, 6(2): ytac032. DOI: 10.1093/ehjcr/ytac032.

GOMES A, JAINANDUNSING J S, VAN ASSEN S, et al . A standardized approach to treat complex aortic valve endocarditis: a case series[J ] . J Cardiothorac Surg, 2018, 13(1): 32. DOI: 10.1186/s13019-018-0715-8.

KLUCKNER M, ENZMANN F, GRUBER L, et al . Risk of permanent pacemaker implantation following bentall operation[J ] . Semin Thorac Cardiovasc Surg, 2023, 35(4): 639-646. DOI: 10.1053/j.semtcvs.2022.06.005.

BRADEL L, KASHYAP K, JABBOUR F, et al . The infectious tale of aerococcal aortic endocarditis: cardiac pacing in acute aortic insufficiency with complete heart block as a bridge to aortic valve replacement[J ] . Cureus, 2021, 13(9): e17921. DOI: 10.7759/cureus.17921.

KASKAR A, BOHRA D V, RAO K R, et al . Primary or secondary Bentall-De Bono procedure: are the outcomes worse?[J ] . Asian Cardiovasc Thorac Ann, 2019, 27(4): 271-277. DOI: 10.1177/0218492319832775.

KODA Y, OKADA K. Clinical outcomes of aortic root reoperation[J]. Kyobu Geka, 2021, 74(10): 763-769.

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