Bentall procedure with composite tissue valve conduit
- VernacularTitle:用自制生物瓣复合管道行Bentall手术
- Author:
Changqing GAO
;
Cangsong XIAO
;
Bojun LI
- Publication Type:Journal Article
- Keywords:
Aortic valve insufficiency Heart valve prosthesis Bioprosthesis Blood vessel prosthesis Cardiac surgical procedures
- From:Chinese Journal of Thoracic and Cardiovascular Surgery
1995;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the clinical experience of Bentall procedure with composite tissue valve conduit. Methods Five patients were diagnosed as severe aortic regurgitation with dilatation of Valsava sinus and sinotubular junction and ascending aorta. Mean age of patients was (55.8?9.4) years (range 47～67). After median sternotomy , cardiopulmonary bypass was established using a single two-stage venous cannula. Temperature was brought to 28℃. After the ascending aorta was occluded, an aortotomy was made and aortic valve was excised. Aorta was removed from sinuses of Valsalva except for generous buttons around coronary ostia. After sizing the aortic annulus, an appropriate-size tissue valve and woven dacron conduit (3 mm greater in diameter than the tissue valve) were chosen to build a composite conduit. It was attached to annulus of aortic valve with pledget-reinforced horizontal mattress stitches to replace the aortic valve and ascending aorta as an en bloc procedure (Bentall procedure). In 2 cases, Coronary artery bypass grafting was performed with greater saphenous vein anastomosed distally to left anterior descending artery and proximately to conduit. Results All cases recovered uneventfully and they were discharged without any postoperative complications. Echocardiography was repeated before discharge. Mean aortic pressure gradient was (18.3?7.6) mmHg. Left ventricular dimension was significantly reduced [(58.8?6.3)mm vs. (43.7?3.1)mm]after operations(P0.05). Follow-up was 2 to 8 months. Conclusion With composite tissue valve conduit, Bentall procedure to replace the aortic valve and ascending aorta as an en bloc procedure is feasible and safe for the elderly patients. A long-term follow-up for the function and structure of tissue valve is needed.
