Mini-root Technique for Aortic Root Diseases: A Mid-term Follow-up Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

NIUZhao-zhuo ,  CHIYi-fan , HOUWen-ming , SUNLong , SHENGWei , LINMing-shan

Department of Cardiac Surgery, Qingdao Municipal Hospital, Qingdao 266071, Shandong, P. R. China;

Corresponding author：

CHIYi-fan, Email: rudolfniu@163.com

Keywords：

Mini-root technique; Mafan syndrome; Aortic root diseases; Cardiac surgery

DOI：

10.7507/1007-4848.20150056

Video：

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Objective To evaluate the clinical effect of modified mini-root operation on aortic root diseases with the short and middle term follow-up results. Methods We retrospectively analyzed the data of thirty-one patients of modified mini-root operations between March 2008 to September 2012. There were 22 male and 9 female patients with mean age of 47.2±21.3 years(ranged from 28 to 71 years). Fifteen patients were diagnosed with acute aortic dissection(Standford A). Thirteen patients were of Marfan syndrome including 8 patients with aortic dissection and 3 patients of bi-leaflet aortic valve malformation with aortic dissection. The patients were followed up for 6 months to 50 months. Thirteen patients of mini-root operation without other procedure(mini-root operation group) were selected to compare with 8 patients of Bentall operation(Bentall operation group). Some clinical indexes were compared between the two groups. Results Three patients died in hospital, in which 1 died from low cardiac out-put syndrome and multiple organ failure, 1 from descending aortic aneurysm rupture, and 1 from acute cerebral infarction. Three patients suffered with acute renal insufficiency and received hemodialysis. During the follow-up, 1 patient received continuous kidney dialysis treatment, and 3 patients performed reoperation. Compared with the Bentall group, the cardiopulmonary bypass time was shorter (108.5±20.8 min vs. 138.5±19.0 min), postoperative blood transfusion volume in the first 24 h was less(661.6±135.0 ml vs. 1 381.2±517.5 ml) than those in the mini-root group. Conclusion Modified mini-root technique can significantly shorten the operation time and reduce the amount of blood transfusion in the treatment of aortic root diseases. The modified mini-root technique has obvious effect on selected aortic root diseases during perioperative period.

Citation： NIUZhao-zhuo, CHIYi-fan, HOUWen-ming, SUNLong, SHENGWei, LINMing-shan. Mini-root Technique for Aortic Root Diseases: A Mid-term Follow-up Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 192-197. doi: 10.7507/1007-4848.20150056 Copy

1.	孙立忠, 常谦, 郑军, 等.主动脉根部替换术231例临床分析.中华医学杂志, 2000, 80(10):729-731.
2.	Ergin MA, Spielvogel D, Apaydin A, et al.Surgical treatment of the dilated ascending aorta:when and how? Ann Thorac Surg, 1999, 67(6):1834-1839.
3.	Bentall H, De Bono A.A technique for complete replacement of the ascending aorta.Thorax, 1968, 23(4):338-339.
4.	徐志云, 邹良建, 宋智钢, 等.升主动脉根部瘤的外科治疗.中国胸心血管外科临床杂志, 2006, 13(6):374-377.
5.	刘峰, 胡建国, 周新民, 等.Bentall手术后早期并发症的发生原因及处理.中国胸心血管外科临床杂志, 2006, 13(3):199-201.
6.	Byrne JG, Karavas AN, Aklog L, et al.Aortic valve reoperation after homograft or autograft replacement.J Heart Valve Dis, 2001, 10(4):451-457.
7.	Angell WW, Pupello DF, Bessone LN.Partial inclusion aortic root replacement with the pulmonary autograft valve.J Heart Valve Dis, 1993, 2(4):388-394.
8.	池一凡, Mesana TH.同种异体带瓣主动脉移植治疗累及主动脉瓣的感染性心内膜炎临床分析.中国循环杂志, 2005, 20(1):54-56.
9.	池一凡, 孙忠东, 侯文明, 等.三种不同手术方式同种异体血管主动脉根部置换的临床效果.中国胸心血管外科临床杂志, 2005, 12(1):48-49.
10.	池一凡, 孙忠东, 侯文明, 等.改良Mini-root手术在马方综合征中的应用.心肺血管病杂志, 2009, 28(5):364-365.
11.	李继勇, 张健群, 孙衍庆, 等.升主动脉成形人工血管外包裹治疗儿童马方综合征.心肺血管病杂志, 2008, 27(1):11-12.
12.	Kouchoukos NT, Wareing TH, Murphy SF, et al.Sixteen year experience with aortic root replacement.Results of 172 operations.Ann Surg, 1991, 214(3):308-320.
13.	谢进生, 林多茂, 杨毅, 等.83例主动脉根部疾病经典和非经典新术式外科治疗的临床经验和体会.心肺血管病杂志, 2007, 26(3):132-133.
14.	郑斯宏, 孙衍庆, 孟旭, 等.马方综合征主动脉根部瘤手术治疗84例经验.中华医学杂志, 2005, 85(32):2279-2282.
15.	孙立忠, 田良鑫, 常谦, 等.保留主动脉瓣的主动脉根部替换术(David术).中华医学杂志, 2003, 83(9):803-804.
16.	孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42(13):812-816.
17.	池一凡, 孙忠东, 侯文明, 等.同种异体带瓣主动脉行主动脉根部替换85例随访结果.中国循环杂志, 2004, 19(2):142-144.
18.	Lopes S, Calvinho P, de Oliveira F, et al.Allograft aortic root replacement in complex prosthetic endocarditis.Eur J Cardiothorac Surg, 2007, 32(1):126-132.
19.	Okada K, Tanaka H, Takahashi H, et al.Aortic root replacement for destructive aortic valve endocarditis with left ventricular-aortic discontinuity.Ann T horac Surg, 2008, 85(3):940-945.
20.	徐志云, 邹良建, 陆方林, 等.严重主动脉瓣感染性心内膜炎患者主动脉根部置换的方法与疗效.中国胸心血管外科临床杂志, 2009, 16(2):82-85.

1. 孙立忠, 常谦, 郑军, 等.主动脉根部替换术231例临床分析.中华医学杂志, 2000, 80(10):729-731.
2. Ergin MA, Spielvogel D, Apaydin A, et al.Surgical treatment of the dilated ascending aorta:when and how? Ann Thorac Surg, 1999, 67(6):1834-1839.
3. Bentall H, De Bono A.A technique for complete replacement of the ascending aorta.Thorax, 1968, 23(4):338-339.
4. 徐志云, 邹良建, 宋智钢, 等.升主动脉根部瘤的外科治疗.中国胸心血管外科临床杂志, 2006, 13(6):374-377.
5. 刘峰, 胡建国, 周新民, 等.Bentall手术后早期并发症的发生原因及处理.中国胸心血管外科临床杂志, 2006, 13(3):199-201.
6. Byrne JG, Karavas AN, Aklog L, et al.Aortic valve reoperation after homograft or autograft replacement.J Heart Valve Dis, 2001, 10(4):451-457.
7. Angell WW, Pupello DF, Bessone LN.Partial inclusion aortic root replacement with the pulmonary autograft valve.J Heart Valve Dis, 1993, 2(4):388-394.
8. 池一凡, Mesana TH.同种异体带瓣主动脉移植治疗累及主动脉瓣的感染性心内膜炎临床分析.中国循环杂志, 2005, 20(1):54-56.
9. 池一凡, 孙忠东, 侯文明, 等.三种不同手术方式同种异体血管主动脉根部置换的临床效果.中国胸心血管外科临床杂志, 2005, 12(1):48-49.
10. 池一凡, 孙忠东, 侯文明, 等.改良Mini-root手术在马方综合征中的应用.心肺血管病杂志, 2009, 28(5):364-365.
11. 李继勇, 张健群, 孙衍庆, 等.升主动脉成形人工血管外包裹治疗儿童马方综合征.心肺血管病杂志, 2008, 27(1):11-12.
12. Kouchoukos NT, Wareing TH, Murphy SF, et al.Sixteen year experience with aortic root replacement.Results of 172 operations.Ann Surg, 1991, 214(3):308-320.
13. 谢进生, 林多茂, 杨毅, 等.83例主动脉根部疾病经典和非经典新术式外科治疗的临床经验和体会.心肺血管病杂志, 2007, 26(3):132-133.
14. 郑斯宏, 孙衍庆, 孟旭, 等.马方综合征主动脉根部瘤手术治疗84例经验.中华医学杂志, 2005, 85(32):2279-2282.
15. 孙立忠, 田良鑫, 常谦, 等.保留主动脉瓣的主动脉根部替换术(David术).中华医学杂志, 2003, 83(9):803-804.
16. 孙立忠, 刘志刚, 常谦, 等.主动脉弓替换加支架"象鼻"手术治疗Stanford A型主动脉夹层.中华外科杂志, 2004, 42(13):812-816.
17. 池一凡, 孙忠东, 侯文明, 等.同种异体带瓣主动脉行主动脉根部替换85例随访结果.中国循环杂志, 2004, 19(2):142-144.
18. Lopes S, Calvinho P, de Oliveira F, et al.Allograft aortic root replacement in complex prosthetic endocarditis.Eur J Cardiothorac Surg, 2007, 32(1):126-132.
19. Okada K, Tanaka H, Takahashi H, et al.Aortic root replacement for destructive aortic valve endocarditis with left ventricular-aortic discontinuity.Ann T horac Surg, 2008, 85(3):940-945.
20. 徐志云, 邹良建, 陆方林, 等.严重主动脉瓣感染性心内膜炎患者主动脉根部置换的方法与疗效.中国胸心血管外科临床杂志, 2009, 16(2):82-85.

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Mini-root Technique for Aortic Root Diseases: A Mid-term Follow-up Study

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