Analysis Of The Curative Effect Of Bentall Operation In The Treatment Of Aortic Root Diseases

OBJECT:To summarize the clinical experience of patients who underwent Bentall surgery for ascending aortic root diseases in our hospital via statistical analysis of their relevant case data,and objectively evaluate the efficacy of Bentall in the treatment of various aortic root diseases.Methods:A total of 317 patients who underwent Bentall surgery in our hospital from January2005 to December 2017 were retrospectively studied,and their related clinical data and follow-up study results were analyzed in detail.Several key factors for the success of the surgery were discussed and the possible causes of complications were analyzed.Moreover,countermeasures were taken,and the long-term survival of patients was observed in the follow-up study.Result:The evaluation of the Bentall surgery was affected by the complicated procedure and prolonged duration of combined aortic arch surgery.Therefore,patients with combined aortic arch surgery were excluded from this group of studies.Six of the remaining 146 patients died during hospitalization.Echocardiographic indicators were compared between the two groups preoperatively and 1 week postoperatively,and their characteristics were statistically studied and clinically analyzed.The results showed that the left ventricular end-diastolic diameter of the patients were significantly reduced by comparison with the echocardiographic indicators one week postoperatively,with a statistically significant difference(P < 0.05).Postoperative follow-up time ranged from 19 to 180 months,with a mean follow-up time of 77.6 ±40.7 months.During the follow-up period,10 patients were lost to follow-up and 11 patients died.The 3-year,5-year,10-year and 15-year average survival rates of patients undergoing surgery in the whole group were 93.1%,89.6%,80.2% and67.4%,respectively.Follow-up showed that cardiac function was improved in all patients postoperatively compared with that preoperatively.The main postoperative long-term complications were cardiac failure and anticoagulation-related bleeding Patients with Marfan syndrome had a lower risk of early postoperative bleeding compared to patients with non-Marfan syndrome,but a higher risk of long-term aortic dissection.Conclusion:Bentall operation is a classic operation for ascending aortic root disease,with high success rate and definite surgical treatment effect.HHowever,during the operation,care should be taken to protect the myocardium and reduce the tension of the coronary anastomosis.Postoperative heart failure patients should pay attention to whether they have coronary artery disease.After the operation,the coagulation function should be reviewed regularly and the anticoagulation drug treatment should be adjusted.For some patients,the anticoagulation standard can be appropriately reduced.