WANG Xianzhi 1 , LIANG Jixiang 2 , WANG Huan 3 , ZHANG Gen 3 , DENG Zhigang 4 , HE Dongquan 1 , MU Cunfu 1 , ZHANG Wenlin 1 , XUE Chunzhu 1 , HE Yang 1 , LI Dianyuan 3
  • 1. Department of Thoracic and Cardiac Surgery, The First People’s Hospital of Guangyuan, Guangyuan, 628000, Sichuan, P. R. China;
  • 2. The State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710000, P. R. China;
  • 3. Department of Cardiovascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Jiangsu, China;
  • 4. Department of Cardiovascular Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China;
LI Dianyuan, Email: drdianyuanli@163.com
Aortic root dilatation; pericardium; Bentall operation
10.7507/1007-4848.202407047
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Objective  To explore the feasibility of modified Bentall operation with pericardium lining in patients with aortic root dilatation (ARD). Methods This study was a retrospective study. From January 2023 to February 2024, the patients were selected for treatment in Suzhou Municipal Hospital, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University and Guangyuan First People's Hospital. The preoperative clinical and imaging evaluation data (including echocardiography and CT of aortic root and whole aorta), the data of coronary intervention, the surgical effect and the postoperative follow-up results were collected. All patients were treated with improved Bentall operation with "pericardium lining": the aortic valve was replaced, and the autologous pericardium was divided into three parts according to the circumferential diameter of the aortic valve ring measured by the valve measuring instrument, and sutured with to the valve ring respectively; two pericardial slices "opened the window" and anastomosed anastomosis with the left and right coronary artery openings; the pericardial piece was sutured with to the aortic sinus wall to form a whole, narrowing the sinus. Artificial blood vessels were used to suture the proximal and distal aorta without aortic root-right atrial shunt. Results  Five patients were collected, aged from 37 to 68 years. The average STS risk score was 3.4%. The preoperative ascending aorta diameter was (56.4±16.6) mm, the preoperative left ventricular end diastolic diameter was (62.0±9.0) mm, and the preoperative left ventricular ejection fraction was (56.0±8.0%. The time of aortic occlusion was (129.6±50.4) min, and the time of cardiopulmonary bypass was (188.2±113.8) min. Echocardiography showed that the diameter of ascending the ascending aorta was (30.2±4.8) mm, the end diastolic diameter of left the left ventricle was (48.2±8.8) mm, and the left ventricular ejection fraction was 51.4%±9.6%. The operation was successfully completed, and the immediate effect was satisfactory. There were no complications during the operation. There was no death and reoperation no reoperation during the follow-up period. Conclusion  For patients with ARD, the preliminary results of improved Bentall operation with "pericardium lining" are satisfactory and the technique is feasible.