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.	孫立忠, 常謙, 鄭軍, 等.主動脈根部替換術231例臨床分析.中華醫學雜志, 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, 鄒良建, 宋智鋼, 等.升主動脈根部瘤的外科治療.中國胸心血管外科臨床雜志, 2006, 13(6):374-377.
5.	劉峰, 胡建國, 周新民, 等.Bentall手術后早期并發癥的發生原因及處理.中國胸心血管外科臨床雜志, 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.同種異體帶瓣主動脈移植治療累及主動脈瓣的感染性心內膜炎臨床分析.中國循環雜志, 2005, 20(1):54-56.
9.	池一凡, 孫忠東, 侯文明, 等.三種不同手術方式同種異體血管主動脈根部置換的臨床效果.中國胸心血管外科臨床雜志, 2005, 12(1):48-49.
10.	池一凡, 孫忠東, 侯文明, 等.改良Mini-root手術在馬方綜合征中的應用.心肺血管病雜志, 2009, 28(5):364-365.
11.	李繼勇, 張健群, 孫衍慶, 等.升主動脈成形人工血管外包裹治療兒童馬方綜合征.心肺血管病雜志, 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.	謝進生, 林多茂, 楊毅, 等.83例主動脈根部疾病經典和非經典新術式外科治療的臨床經驗和體會.心肺血管病雜志, 2007, 26(3):132-133.
14.	鄭斯宏, 孫衍慶, 孟旭, 等.馬方綜合征主動脈根部瘤手術治療84例經驗.中華醫學雜志, 2005, 85(32):2279-2282.
15.	孫立忠, 田良鑫, 常謙, 等.保留主動脈瓣的主動脈根部替換術(David術).中華醫學雜志, 2003, 83(9):803-804.
16.	孫立忠, 劉志剛, 常謙, 等.主動脈弓替換加支架"象鼻"手術治療Stanford A型主動脈夾層.中華外科雜志, 2004, 42(13):812-816.
17.	池一凡, 孫忠東, 侯文明, 等.同種異體帶瓣主動脈行主動脈根部替換85例隨訪結果.中國循環雜志, 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, 鄒良建, 陸方林, 等.嚴重主動脈瓣感染性心內膜炎患者主動脈根部置換的方法與療效.中國胸心血管外科臨床雜志, 2009, 16(2):82-85.

1. 孫立忠, 常謙, 鄭軍, 等.主動脈根部替換術231例臨床分析.中華醫學雜志, 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, 鄒良建, 宋智鋼, 等.升主動脈根部瘤的外科治療.中國胸心血管外科臨床雜志, 2006, 13(6):374-377.
5. 劉峰, 胡建國, 周新民, 等.Bentall手術后早期并發癥的發生原因及處理.中國胸心血管外科臨床雜志, 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.同種異體帶瓣主動脈移植治療累及主動脈瓣的感染性心內膜炎臨床分析.中國循環雜志, 2005, 20(1):54-56.
9. 池一凡, 孫忠東, 侯文明, 等.三種不同手術方式同種異體血管主動脈根部置換的臨床效果.中國胸心血管外科臨床雜志, 2005, 12(1):48-49.
10. 池一凡, 孫忠東, 侯文明, 等.改良Mini-root手術在馬方綜合征中的應用.心肺血管病雜志, 2009, 28(5):364-365.
11. 李繼勇, 張健群, 孫衍慶, 等.升主動脈成形人工血管外包裹治療兒童馬方綜合征.心肺血管病雜志, 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. 謝進生, 林多茂, 楊毅, 等.83例主動脈根部疾病經典和非經典新術式外科治療的臨床經驗和體會.心肺血管病雜志, 2007, 26(3):132-133.
14. 鄭斯宏, 孫衍慶, 孟旭, 等.馬方綜合征主動脈根部瘤手術治療84例經驗.中華醫學雜志, 2005, 85(32):2279-2282.
15. 孫立忠, 田良鑫, 常謙, 等.保留主動脈瓣的主動脈根部替換術(David術).中華醫學雜志, 2003, 83(9):803-804.
16. 孫立忠, 劉志剛, 常謙, 等.主動脈弓替換加支架"象鼻"手術治療Stanford A型主動脈夾層.中華外科雜志, 2004, 42(13):812-816.
17. 池一凡, 孫忠東, 侯文明, 等.同種異體帶瓣主動脈行主動脈根部替換85例隨訪結果.中國循環雜志, 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, 鄒良建, 陸方林, 等.嚴重主動脈瓣感染性心內膜炎患者主動脈根部置換的方法與療效.中國胸心血管外科臨床雜志, 2009, 16(2):82-85.

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