再次Bentall手术应用于主动脉根部病变的病例系列报道

彭晓波; 李帆; 李畑波; 刘宸铖; 徐博; 夏晗; 肖颖彬; 王咏

doi:10.16016/j.2097-0927.202304019

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再次Bentall手术应用于主动脉根部病变的病例系列报道

临床医学 | 更新时间：2026-01-09

- 再次Bentall手术应用于主动脉根部病变的病例系列报道
- Redo-Bentall surgery for aortic root lesions: a report of case series
- 陆军军医大学学报 2024年46卷第10期页码：1158-1163
- 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：
  
  [王咏，E-mail：wy003236@163.comWANG Yong, E-mail: wy003236@163.com
- 基金信息：
  
  重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0200);陆军军医大学临床技术创新培育项目(CX2019JS216)
- DOI：10.16016/j.2097-0927.202304019
  中图分类号： R543.106;R615;R654.2
- 收稿：2023-04-05，
  
  修回：2023-10-22，
  
  纸质出版：2024-05-30
- 稿件说明：
移动端阅览
彭晓波, 李帆, 李畑波, 等. 再次Bentall手术应用于主动脉根部病变的病例系列报道[J]. 陆军军医大学学报, 2024,46(10):1158-1163.

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.
彭晓波, 李帆, 李畑波, 等. 再次Bentall手术应用于主动脉根部病变的病例系列报道[J]. 陆军军医大学学报, 2024,46(10):1158-1163. DOI： 10.16016/j.2097-0927.202304019.

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

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