CAJ | 학술논문

目的：总结Bentall手术治疗主动脉根部瘤的临床经验。方法采用Bentall手术治疗主动脉根部瘤21例，其中主动脉瓣中-重度关闭不全伴主动脉根部瘤样扩张14例，主动脉瓣中-重度狭窄伴主动脉根部瘤样扩张1例，马凡综合征3例，DeBakeyII型主动脉夹层3例。术前心功能分级（ NYHA） I级2例，II级14例，III级5例。结果全组死亡1例，其余无术后并发症（低心排综合征、严重心律失常、二次开胸止血）。术后随访20例恢复良好，心功能I～Ⅱ级。结论 Bentall手术是治疗主动脉根部瘤的首选方法。改善吻合技术、缩短体外循环及深低温停循环时间、保证移植后冠状动脉通畅是提高手术成功率的关键因素。
목적：총결Bentall수술치료주동맥근부류적림상경험。방법채용Bentall수술치료주동맥근부류21례，기중주동맥판중-중도관폐불전반주동맥근부류양확장14례，주동맥판중-중도협착반주동맥근부류양확장1례，마범종합정3례，DeBakeyII형주동맥협층3례。술전심공능분급（ NYHA） I급2례，II급14례，III급5례。결과전조사망1례，기여무술후병발증（저심배종합정、엄중심률실상、이차개흉지혈）。술후수방20례회복량호，심공능I～Ⅱ급。결론 Bentall수술시치료주동맥근부류적수선방법。개선문합기술、축단체외순배급심저온정순배시간、보증이식후관상동맥통창시제고수술성공솔적관건인소。
Objective To summarize the experience of Bentall operation for aortic root aneurysm .Methods 21 patients with ascending aortic root aneurysm underwent Bentall operation .Among the 21 cases,there were 14 cases of ascending aortic aneurysm and over moderate and severe aortic valve regurgitation ,1 case of ascending aortic aneurysm and over moderate and severe aortic valve stenosis,3 cases of Marfan syndrome,and 3 cases of acute dissecting aortic aneurysm.Before operation,2 cases were ranked in NYHA function class I , 14 cases in class II and 5 cases in class III.Results One patient died in hospi-tal.No postoperative complications ( low cardiac output , severe arrhythmia and reoperation for hemostasis following open-heart surgery)occurred in the others.Follow-ups showed that 20 patients successfully recovered,with heart function improving to classes I-II.Conclusion Bentall procedure should be the optimal option for ascending aortic root aneurysm .Furthermore,to improve surgical technique ,reduce CPB time , decrease myocardial injury and ensure coronary artery blood flow are the essen-tial factors for surgical success .