人工血管外翻改良Bentall手术治疗主动脉根部瘤的短期疗效

Short-Term Efficacy of Modified Bentall Procedure with Outward Expansion of Artificial Graft for Aortic Root Aneurysm

摘要: 目的：探讨人工血管外翻改良Bentall手术在治疗主动脉瓣病变伴升主动脉瘤样扩张患者中的临床应用价值及手术效果。方法：回顾性分析2020年1月~2024年1月在青岛大学附属医院西海岸院区心血管外科接受Bentall手术治疗的44例患者的临床资料。其中23例行人工血管外翻改良Bentall手术，21例行纽扣法Bentall手术。统计分析患者的术前临床资料、术中、术后指标及随访结果。结果：两组手术均未发生术中死亡。人工血管外翻改良Bentall手术组的体外循环时间、术后24小时引流量、术后拔除引流管时间、术后住院时间、术中输注血小板、凝血因子费用均少于纽扣法Bentall手术，差异具有统计学意义(P < 0.05)。两组患者术后复查左室内径、射血分数比较，差异无统计性意义(均P > 0.05)。结论：人工血管外翻改良Bentall手术，能有效减少术中近端吻合口出血、渗血，是一种安全有效的手术方式。

Abstract: Objective: To explore the clinical application and surgical outcomes of the modified Bentall procedure with an outward expansion of the artificial graft in the treatment of patients with aortic valve disease complicated by ascending aortic aneurysm-like dilation. Methods: A retrospective analysis was conducted on the clinical data of 44 patients who underwent Bentall surgery between January 2020 and January 2024 at the cardiovascular surgery department of The Affiliated Hospital of Qingdao University, West Coast Branch. Among them, 23 patients underwent the modified Bentall procedure with an outward expansion of the artificial graft, and 21 patients underwent the button-type Bentall procedure. Preoperative clinical data, intraoperative parameters, postoperative outcomes, and follow-up results were statistically analyzed. Results: No intraoperative deaths occurred in either group. The modified Bentall procedure group had significantly shorter cardiopulmonary bypass time, lower postoperative 24-hour drainage volume, earlier removal of drainage tubes, shorter postoperative hospital stay, and lower costs for platelet and coagulation factor transfusion compared to the button-type Bentall procedure group (P < 0.05). No statistically significant differences were found between the two groups in postoperative left ventricular diameter and ejection fraction (both P > 0.05). Conclusion: The modified Bentall procedure with an outward expansion of the artificial graft can effectively reduce proximal anastomotic bleeding and oozing, making it a safe and effective surgical approach.