Clinical Experience And Early Efficacy Analysis Of Bentall Surgery For Aortic Root Disease

Objective: Bentall surgery is a common surgical method for the treatment of aortic root disease and aortic valve disease caused by various reasons,and it can achieve satisfactory results.However,for patients with severe left ventricular enlargement and severe left ventricular dysfunction,Bentall surgery for cardiac arrest often has a poor prognosis.During the Bentall operation,the heart muscle is perfused with oxygenated blood to avoid myocardial ischemia and hypoxia,ischemia-reperfusion injury,and has a good myocardial protection effect.This study compared the mild hypothermia retrograde perfusion beating Bentall operation and cardiac beating Bentall operation to analyze the early clinical efficacy of different myocardial protection Bentall operations.Methods: A retrospective analysis of the clinical data of 74 patients undergoing Bentall operation in cardiothoracic surgery at the First Affiliated Hospital of Guangxi Medical University from December 2015 to December 2019.According to the way of myocardial perfusion during operation,it is divided into cardiac arrest surgery group and mild hypothermia retrograde perfusion cardiac arrest group.The echocardiography results of patients before operation,7 days after operation,3 months after operation,and 1 year after operation were analyzed.The data are processed statistically using SPSS Statistics25 software.Result: Two of the 74 patients died during the perioperative period,both of which were postoperative low cardiac output syndrome.Three patients died during the follow-up,of which 1 died of unexplained disease 6 years after surgery and 2 died of cerebral infarction.5 cases had serious complications,2cases were bleeding due to excessive anticoagulation;3 cases had cerebral infarction complications,and 1 case survived after conservative treatment.The LVEDD and LVESD of patients in the cardiac arrest group at all time points(preoperative,1 week after surgery,3 months after surgery,and 1 year after surgery)were significantly lower than that before surgery,and the difference was statistically significant(p<0.001);EF The value decreased slightly at 1week after operation compared to before operation,and increased significantly at 3 months and 1 year after operation,and the difference was statistically significant(p<0.001);LAD at each time point after operation was compared with that before operation No statistical difference(p>0.05);IVSD increased slightly compared with preoperative one week after operation,the difference was statistically significant(p<0.05),and there was no significant difference in IVSD compared with preoperative at other time points(p >0.05).The LVEDD and LVESD of patients in the mild hypothermia retrograde heart beating group decreased at all time points(preoperative,1 week after surgery,3months after surgery,and 1 year after surgery),the difference was statistically significant(P<0.001);EF value increased significantly at 1 week after operation,3 months after operation,and 1 year after operation,the difference was statistically significant(p<0.001);LAD and operation at each time point after operation Before the comparison p>0.05,the difference was not statistically significant;there was no statistically significant difference between the postoperative IVSD and the preoperative comparison(p>0.05).Conclusion: 1.For patients with good cardiac function and no serious enlargement of the left ventricle,cardiac arrest Bentall surgery can achieve satisfactory results.2.The mild hypothermia retrograde perfusion beating Bentall operation for patients with severe left ventricular enlargement and severely weakened cardiac function can reduce the incidence of complications such as perioperative malignant arrhythmia and low cardiac output syndrome.