Clinical Effect Of Modified B Entall Operation Of Tunnel Method On Aortic Root Aneurysm

Objective:The purpose of this study was to explore the clinical effect of modified Bentall operation of tunnel method on treating aortic root aneurysm.Aims and Methods:Retrospective analysis was conducted on the clinical materials of 35 patients with aortic root aneurysm and lesion of aortic valve who were treated in the cardiac surgery department of The First Affiliated Hospital of Zhengzhou University from July 2015 to July 2019.These patients was divided into observation group(20 patients who were treated with modified Bentall operation of tunnel method)and control group(15 patients who were treated with Bentall operation of button method)according to operation method.The blocking time of aorta,in vitro cycling time,transfusion,auxiliary time of ventilator,intensive care time,postoperative hospital stays,postoperative complications,as well as the diameter of aortic root,EF value and left ventricular end diastolic diameter displayed in color ultrasound in the materials of the patients who were performed with postoperative follow-up visit for half a year for the two groups of patients were observed.Result:1 patient in the control group died of low cardiac output syndrome after the operation,without postoperative data.There was no statistical significance(P>0.05)in the difference of preoperative age,inner diameter of ascending aorta,left ventricular end diastolic diameter and left ventricular ejection fraction between the two groups.There was no statistical significance(P>0.05)in the difference of intraoperative blocking time of aorta and in vitro cycling time.The intraoperative transfusion frequency for the observation was less than that for the control group,and the difference was of statistical significance(P<0.05);there was no statistical significance(P>0.05)in detention time in ICU and postoperative inpatient days between the two groups of patients;the auxiliary time of ventilator for the observation group was less than that for the control group,and the difference was of statistical significance(P<0.05);there was no statistical significance(P>0.05)in the occurrence rate of respiratory insufficiency,low cardiac output syndrome,insufficiency of nervous system,too many volume of drainage for the postoperative complications between the two groups of patients;malignant arrhythmia for the conventional observation group was less than that for the control group,and the difference was of statistical significance(P<0.05).From the materials related to postoperative follow-up visit There was no statistical significance(P>0.05)in difference of the inner diameter of aorta,left ventricular end diastolic diameter and ejection fraction displayed in the postoperative reviewed color ultrasound between the two groups of patients.Conclusion:The retrospective research was made on the clinical effect of the modified Bentall operation of tunnel method firstly carried out by the center on treating aortic root aneurysm.Compared with the improved Bental operation of button method,it can be seen that:Ⅰ.The modified Bentall operation of tunnel method has definite effect on treating aortic root aneurysm,which can reach the expected therapeutic effect completely.Ⅱ.When being used for treating aortic root aneurysm,the modified Bentall operation of tunnel method is characterized by wide operative field,convenient anastomosis,small tension for the anastomotic stoma,no formation of pseudoaneurysm in the anastomotic stoma,no occurrence of twist and fracture phenomenon for the coronary artery,less bleeding,few postoperative complications,which are the advantages compared with the modified Bentall operation of button method.Ⅲ.The modified Bentall operation of tunnel method is especially suitable for the patients with the distance of less than 2cm between the opening of coronary artery and aortic valve.It is the safer and more effective operation selection for this kind of patients,promoting the improvement and development of Bentall operation.