초록접수 현황
| 15F-112 | 구연 발표 |
Mid-term Durability of the Constructed Composite Graft in Bio-bentall Procedure
Dong Jin Kim¹, Jeong-Won Kim¹, Hyung Tae Sim¹, Hyoung Woo Chang¹, Jae Suk Yoo¹, Kwang Ree Cho¹, Chan-Young Na², Jae-Hyun Kim², Sam-Sae Oh³, Kilsoo Yie⁴
Department of Thoracic and Cardiovascular Surgery, Sejong Heart Institute, Sejong General Hospital, Gyeonggi-do, Republic of Korea¹, Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea², Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea³, Department of Thoracic and Cardiovascular Surgery, Jeju Halla General Hospital, Jeju-do, Republic of Korea⁴
Background : To assess the mid-term durability of constructed composite graft for aortic root replacement (Bio-Bentall procedure), we retrospectively reviewed our institutional experience.
Methods : Between 1998 and 2015, 46 patients (mean age 68.5 ± 4.8(58-82)) underwent aortic root replacement using composite grafts which were reconstructed intraoperatively using bioprosthetic valves and impregnated Dacron tube grafts (Bio-Bentall procedure). Used prosthesis were 27 bovine pericardial valves (mean size 24 ± 2 (19-27)mm) and 19 porcine valves (mean size 24 ± 1 (21-27)mm). To make the composite graft, we selected the Dacron vascular grafts 3mm larger than the size of the valves. The indications for surgery were 42 chronic ascending aortic aneurysms, 3 type A aortic dissection (1 acute), and one porcelain aorta hindering the replacement of the aortic valve. All patients underwent modified Bentall’s operation using button type technique. Arterial cannulation sites were 38 (82.6%)in ascending aorta, and 8 (17.4%) in right axillary artery. Deep hypothermic arrest was used in 4 (8.7%) patients.
Results : Mean Cardiopulmonary bypass and aortic cross clamp time were 217.8 ± 78.9 minutes, 162.7 ± 49.5 minutes, respectively. In-hospital mortality rate was 6.5% (3/46). Causes of deaths were myocardial infarction, stroke and sepsis. Early post-operative transthoracic echocardiography revealed peak and mean pressure gradient across the aortic valve were 22.2 ± 9.7mmHg, 11.5 ± 4.7 mmHg, respectively. During the mean 3.2 (0-9) years follow-up period, the peak and mean aortic valve pressure gradient remained stable as 24.5 ± 11.6 mmHg, and 13.0 ± 6.6mmHg respectively. During the follow-up period, there was a late non-cardiac mortality at post-operative 8 years from intestinal neoplasm. Two patients had stroke without causing limited daily activities. There were no hemorrhagic complications, reoperation for valve failure or endocarditis during the follow up.
Conclusion : Mid-term durability of the constructed composite graft for bio-Bentall procedure was satisfactory in terms of valve functions.
Methods : Between 1998 and 2015, 46 patients (mean age 68.5 ± 4.8(58-82)) underwent aortic root replacement using composite grafts which were reconstructed intraoperatively using bioprosthetic valves and impregnated Dacron tube grafts (Bio-Bentall procedure). Used prosthesis were 27 bovine pericardial valves (mean size 24 ± 2 (19-27)mm) and 19 porcine valves (mean size 24 ± 1 (21-27)mm). To make the composite graft, we selected the Dacron vascular grafts 3mm larger than the size of the valves. The indications for surgery were 42 chronic ascending aortic aneurysms, 3 type A aortic dissection (1 acute), and one porcelain aorta hindering the replacement of the aortic valve. All patients underwent modified Bentall’s operation using button type technique. Arterial cannulation sites were 38 (82.6%)in ascending aorta, and 8 (17.4%) in right axillary artery. Deep hypothermic arrest was used in 4 (8.7%) patients.
Results : Mean Cardiopulmonary bypass and aortic cross clamp time were 217.8 ± 78.9 minutes, 162.7 ± 49.5 minutes, respectively. In-hospital mortality rate was 6.5% (3/46). Causes of deaths were myocardial infarction, stroke and sepsis. Early post-operative transthoracic echocardiography revealed peak and mean pressure gradient across the aortic valve were 22.2 ± 9.7mmHg, 11.5 ± 4.7 mmHg, respectively. During the mean 3.2 (0-9) years follow-up period, the peak and mean aortic valve pressure gradient remained stable as 24.5 ± 11.6 mmHg, and 13.0 ± 6.6mmHg respectively. During the follow-up period, there was a late non-cardiac mortality at post-operative 8 years from intestinal neoplasm. Two patients had stroke without causing limited daily activities. There were no hemorrhagic complications, reoperation for valve failure or endocarditis during the follow up.
Conclusion : Mid-term durability of the constructed composite graft for bio-Bentall procedure was satisfactory in terms of valve functions.
책임저자: Dong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Sejong Heart Institute, Sejong General Hospital, Gyeonggi-do, Republic of Korea
연락처 : Dong Jin Kim, Tel: 010-8012-2108 , E-mail : shallbe@hanmail.net
