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Published on: October 6, 2022
[Problems and management of surgery on aorta and heart in Marfan syndrome]
1Anzhen Hospital, Capital Institute of Medicine, Beijing.
Insights
This study evaluated 71 patients with aortic root aneurysms, primarily caused by medial cystic necrosis. Bentall
Area of Science:
- Cardiovascular Surgery
- Aortic Surgery
- Aortic Aneurysm
Context:
- Medial cystic necrosis is a common cause of aortic root aneurysm and insufficiency.
- Surgical intervention is necessary for these complex cardiovascular conditions.
Purpose:
- To analyze the outcomes of surgical treatment for aortic root aneurysms and/or insufficiency.
- To evaluate the efficacy and complications of Bentall's operation and graft replacement.
Summary:
- 71 patients underwent aortic root aneurysm/insufficiency repair from 1985-1991.
- 61 Bentall operations and 10 graft replacements were performed.
- Overall operative mortality was 6.55%, with infection noted as a complication in later Bentall procedures.
Impact:
- Highlights the risks and challenges in perioperative management of aortic root surgery.
- Provides insights into managing bleeding, myocardial protection, and prosthesis selection.
- Contributes to understanding outcomes for aortic degenerative diseases.
Abstract:
From March 1985 to December 1991, 71 patients of aortic root aneurysm and/or aortic insufficiency underwent operative treatment. All the cases are caused by medial cystic necrosis, a predisposing degenerative change in the aorta proven pathologically. 61 Bentall's operation were done, resection of the aneurysm with dacron grafts replacement were performed in 10 cases, including 7 cases of DeBakey type III dissecting aneurysms. The mortality of previous 53 Bentall's operation was 3.77%, but in the last 8 cases (after February 1991), 2 was lost due to uncontrolled infection. So that the total operative mortality was 6.55% (4/61) in 61 Bentall operations. Some catastrophic problems and countermeasures in perioperative period, which met in this series, such as: time of operation, active bleeding and diffused blood oozing, myocardial protection and malignant arrhythmia, selection of valve prosthesis for composite grafts etc, were discussed in this paper.
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