Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Early Result of Bentall Operation

Bentall 술식의 조기 성적

  • 송명근 (서울중앙병원 울산대학교 의과대학 흉부외과)
  • Published : 1998.02.01
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Abstract

From October 1993 to April 1997, 37 patients(30 male and 7 female patients), ranging in age from 23 to 73 years, were operated for annuloaortic ectasia with or without aortic dissection. Four patients were in New York Heart Association Class I, 10 in Class II, 20 in Class III, and 3 in Class IV. In cases of annuloaortic ectasia with aortic dissection, the surgical treatment in all cases consisted of total replacement of the ascending aorta with composite graft and reimplantation of the coronary arteries to the tube graft. The postoperative complication, as postoperative bleeding or LV dysfunction, was 18%(7 cases) and late mortality for entire group was 2.7%(one death). The period of follow-up ranged from 1 month to 36 months(average 9.6 months). In conclusion, Bentall operation for annuloaortic ectasia with or without aortic dissection is reliable method with low mortality and excellent short-term results.

아산재단 서울중앙병원 흉부외과에서는 1993년 10월부터 1997년 4월 사이에 대동맥륜대동맥 확장환자에서 37례의 Bentall술식을 시행하였다. 환자군의 술전 호흡곤란 정도는 NYHA Class I이 4례, Class II가 10례, Class III가 20례, Class IV가 3례였다. 수술은 대동맥박리증이 동반된 경우 초저체온법(식도체온: 11.8$\pm$1.6!), 완전순환정지, 역행성 대뇌관류법을 시행하였다. 37례 모두 병변이 있는 대동맥벽을 대부분 제거하고 복합이식편이나 대동맥 인조혈관 및 인공판막을 이용하여 상행대동맥과 대동맥판막을 치환하였고, 관상동맥편을 인조혈관에 직접 연결하였다. 수술결과는 합병증은 7례 발생하였으며(18%), 수술사망은 없었으나 뇌혈관 발작으로 인한 1례의 만기 사망이 있었다(2.7%). 퇴원후 추적기간은 1개월에서 36개월까지였으며 평균 9.6개월였다. 결론적으로 대동맥륜대동맥 확장의 수술에 있어 Bentall술식은 안전하고 좋은 수술이라 할 수 있다.

Keywords

References

  1. JAMA v.162 Resection of entire ascending aorta in fusiform aneurysm using cardiac bypass Cooley DA;DeBakey ME
  2. J Thorac Cardiovasc Surg v.48 Aortic insufficiency secondary to aneurysmal changes in the ascending aorta. Surgical management Groves LK;Effler DK;Hawk WA;Gulati K
  3. JAMA v.188 Successful replacement of the entire ascending aorta and aortic valve Wheat MW;Wilson JR;Bartley TD
  4. Thorax v.23 technique for complete replacement of the ascending aorta Bentall H;DeBono A
  5. J Thorac Cardiovasc Surg v.81 Complete replacement of the ascending aorta with reimplantation of the coronary arteries Cabrol C;Pavie A;Gandjabakhch I(et al.)
  6. 대휴외지 v.19 no.1 대동맥판막부전증이 동반된 상행대동맥류의 외과적 치료 조범구;최수승;박영환;조승연
  7. J Thorac Cardiovasc Surg v.27 Surgical Treatment of the Disease Involving Ascending Aorta Baek WK;Kim H;Suh PW(et al.)
  8. J Card Surg v.9 Three Faces of the Bentall Procedure Midulla PS;Ergin MA;Galla J(et al.)
  9. Ann Thorac Surg v.55 Cerebral Metabolism and Circulatory Arrest : Effects of Duration and Strategies for Protection Mault JR;Ohtake S;Klingensmith ME;Heinle JS;Greely WJ;Ungerleider RM
  10. Ann Thorac Surg v.56 Retrograde Cerebral Perfusion Using Pulastile Flow Under Conditions of Profound Hypothermia Mori A
  11. The effect of pulsatile perfusion on cerebral blood flow during profound hypothermia with total circulatory arrest Onoe M;Mori A;Watariida S(et al.)
  12. Ann Thorac Surg v.28 Surgical treatment of ascending aortic aneurysm associated with aortic valve insufficiency McCready RA;Pluth JR
  13. J Thorac Cardiovasc Surg v.92 Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve Kouchoukos NT;Marshall WG;Wedige-Stecher TA
  14. Ann Thorac Surg v.58 Aortic Root Relpacement With a Composite Graft : Results of 69 Operations in 66 Patients Aoyagi S;Kosuga K;Akashi H;Oryoji A;Oishi K