[1]陈枫杰 曾艳 王湘.·论著·单纯Bentall手术治疗主动脉根部瘤合并巨大左心室的临床疗效分析[J].心血管病学进展,2025,(7):642.[doi:10.16806/j.cnki.issn.1004-3934.2024.07.014]
　CHEN Fengjie,ZENG Yan WANG Xian.Clinical Efficacy Analysis of Isolated Bentall Procedure for Aortic Root Aneurysm with Concomitant Severely Enlarged Left Ventricle[J].Advances in Cardiovascular Diseases,2025,(7):642.[doi:10.16806/j.cnki.issn.1004-3934.2024.07.014]
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·论著·单纯Bentall手术治疗主动脉根部瘤合并巨大左心室的临床疗效分析()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年7期
页码:
642
栏目:
论著
出版日期:
2025-07-25

文章信息/Info

Title:
Clinical Efficacy Analysis of Isolated Bentall Procedure for Aortic Root Aneurysm with Concomitant Severely Enlarged Left Ventricle
作者:
102;  102); font-family: Arial;  Verdana;  sans-serif; font-size: 12px; background-color: rgb(255;  255;  255);">陈枫杰 曾艳 王湘
(中国医学科学院阜外医院深圳医院,广东 深圳 518000)
Author(s):
CHEN Fengjie;  ZENG Yan WANG Xian
(Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen, Shenzhen 518000,Guangdong Province,China) E-mailwx5209@163.com
关键词:
主动脉根部瘤; 巨大左心室; Bentall手术
Keywords:
Aortic root aneurysm;  Severely enlarged left ventricle;  Bentall procedure
DOI:
10.16806/j.cnki.issn.1004-3934.2024.07.014
摘要:
目的 本研究旨在评估合并巨大左心室的主动脉根部病变患者行Bentall手术的临床疗效，并探讨手术对患者心功能和预后的影响。方法 回顾性分析2018年1月—2021年12月本院收治的主动脉根部瘤合并巨大左心室并单纯行Bentall手术的患者共26例，男性23例，女性3例；年龄为30～73岁，平均为(51.85±12.5)岁。其中主动脉退行性病变16例，马方综合征5例，主动脉瓣二叶瓣畸形5例。通过配对t检验比较术前、术后1周及术后随访时的左心室舒张末内径（LVEDD）、左心室收缩末内径（LVESD）、左心室射血分数（LVEF）等指标来评估术后心功能恢复情况，并分析术后死亡率和并发症，综合评估手术疗效。结果 本组26例患者中，围手术期无死亡病例。对术后出院的患者进行随访，随访时间12~60个月，平均为(28.0±13.7)个月，24例（92.3%）患者得到随访，2例（7.7%）失访。术后并发症有低心排综合征2例（7.7%），肾功能不全1例（3.9%）。术后1周超声心动图检查，LVEDD为47~75 mm，平均为（58.4±6.9）mm，LVESD为35~56 mm，平均为（43.8±5.5）mm，均明显比术前减小（P＜0.01）；LVEF为25%~68%，平均为(41.4±10.7)%，明显低于术前（P＜0.01）。术后随访时无死亡病例，纽约心功能分级Ⅰ级21例（87.5%），Ⅱ级3例（12.5%），心功能较术前有明显改善(P＜0.01)。术后随访时LVEDD为40~62 mm，平均为（52.3±6.2）mm，LVESD为31~56 mm，平均为（39.4±3.8）mm，均明显比术前减小（P＜0.01）；LVEF为36%~65%，平均为(51.5±8.1)%，较术前明显升高（P＜0.01）。结论 Bentall手术治疗对于合并巨大左心室的主动脉根部病变患者具有良好的临床疗效，术后左心室能进一步缩小，心功能逐步改善。
Abstract:
Objective This study aims to assess the effectiveness of the Bentall procedure in patients with aortic root aneurysm and severely enlarged left ventricle,and to explore its impact on cardiac function and prognosis of the patients. Methods A retrospective analysis was conducted on 26 patients (23 males, 3 females) with aortic root aneurysm and enlarged left ventricle who underwent the isolated Bentall procedure between January 2018 and December 2021. The age ranged from 30 to 73 years, with an average of (51.85±12.5) years. There were 16 cases of degenerative aortic disease, 5 cases of Marfan syndrome,and 5 cases of bicuspid aortic valve malformation. The recovery of postoperative cardiac function was evaluated by comparing indicators such as left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and left ventricular ejection fraction (LVEF) preoperatively, one week?postoperatively, and during the postoperative follow-up through paired t-tests. The postoperative mortality and complications were analyzed to comprehensively evaluate surgical outcomes. Results No perioperative deaths occurred among the 26 patients. The discharged postoperative patients were followed up for 12 to 60 months[mean,(28.0±13.7)months)]. 24 patients (92.3%) were followed up and 2 patients (7.7%) were lost to follow-up. Postoperative complications included 2 cases (7.7%) of low cardiac output syndrome and 1 case (3.9%) of renal insufficiency. At one week postoperatively, echocardiography examination showed LVEDD of 47～75 mm [mean, (58.4±6.9)mm]and LVESD of 35～56 mm[mean, (43.8±5.5)mm], both significantly reduced from preoperative values (P<0.01). The LVEF was 25%～68% (mean, 41.4%±10.7%), significantly lower than preoperative values ( P<0.01). There were no deaths during the postoperative follow-up. Postoperative New York Heart function assessment included 21 cases (87.5%) of Class I and 3 cases (12.5%) of ClassⅡ,significantly improvement from preoperative values( P<0.01). At the postoperative follow-up, the LVEDD was 40～62 mm[mean,(52.3±6.2)mm] , and the LVESD was 31 ～56 mm[mean,(39.4±3.8)mm],both significantly reduced from preoperative values (P < 0.01). The LVEF was 36% ～65%(mean,51.5%±8.1%), significantly higher than preoperative values(P<0.01). Conclusion The Bentall procedure is effective for patients with aortic root aneurysm and severely enlarged left ventricle ,leading to a reduction in ventricular size and gradual improvement in heart function

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更新日期/Last Update: 2025-09-30