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(P<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。
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%,P<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.
作者
彭晓波
李帆
李畑波
刘宸铖
徐博
夏晗
肖颖彬
王咏
PENG Xiaobo;LI Fan;LI Tianbo;LIU Chencheng;XU Bo;XIA Han;XIAO Yingbin;WANG Yong(Department of Cardiovascular Surgery,PLA Institute of Cardiovascular Surgery,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400037,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2024年第10期1158-1163,共6页
Journal of Army Medical University
基金
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)。
