目的:评估法兰技术改良Bentall手术的早期和晚期结果。
方法:我们回顾了2001年1月至2018年12月在我们研究所接受改良Bentall手术进行牙根置换的63例患者的病历。在大多数情况下,我们通过法兰技术采用了由机械瓣膜或生物假体和Dacron移植物构成的复合移植物。自2011年以来,我们使用了Valsalva移植物。
结果:平均年龄57±16岁,范围16-80例,男性43例。平均随访75±56个月(范围0-216)。到2020年4月1日,我们可以在六个月内跟进61例(97%)。医院死亡率为7.9%(选择性病例为4.8%)。在后期随访中,观察到8人死亡。在bio-Bentall组(n=26)中,无死亡或重大不良瓣膜相关事件(MARVEs)发生.在机械Bentall组中(n=37),七例MARVE,包括两次脑出血和一次脑栓塞,被观察到。bio-bentall组所有患者术后5年无MARVE,93.8%和76.8%在5年和10年无事件发生,分别,在机械Bentall组。
结论:改良Bentall手术18年的结果是可以接受的,在bio-bentall组中提供出色的结果。法兰技术可以使用更大的假体,这可能导致了良好的耐久性与bio-Bentall程序。
OBJECTIVE: To evaluate the early and late outcomes of the modified Bentall procedure with the flanged technique.
METHODS: We reviewed the medical records of 63 patients who had undergone root replacement by the modified Bentall procedure at our institute between January 2001 and December 2018. In most cases, we adopted a composite graft constructed with a mechanical valve or bioprosthesis and a Dacron graft by the flanged technique. Since 2011, we have used Valsalva grafts.
RESULTS: Mean age 57 ± 16 years, range 16-80, male 43 cases. The mean follow-up was 75 ± 56 months (range 0-216). Through April 1, 2020, we could follow up on 61 cases (97%) within a six-month period. Hospital mortality was 7.9% (4.8% in elective cases). In late follow-up, eight deaths were observed. In the bio-Bentall group (n=26), no deaths or major adverse valve-related events (MARVEs) occurred. In the mechanical Bentall group (n=37), seven cases of MARVEs, including two cerebral hemorrhages and one cerebral embolism, were observed. All patients were free from MARVEs at 5 years post procedure in the bio-Bentall group, and 93.8% and 76.8% were event-free at 5 years and 10 years, respectively, in the mechanical Bentall group.
CONCLUSIONS: The 18-year results of the modified Bentall procedure were acceptable, providing excellent outcomes in the bio-Bentall group. The flanged technique enabled the use of a larger prosthesis, which may have resulted in good durability with the bio-Bentall procedure.