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2010, Number 1

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Cir Cir 2010; 78 (1)

Procedimiento de Bentall en la enfermedad aneurismática de la aorta ascendente: mortalidad hospitalaria

Galicia-Tornell MM, Marín-Solís B, Fuentes-Orozco C, Martínez-Martínez M, Villalpando-Mendoza E, Ramírez-Orozco F

Language: Spanish
References: 28
Page: 45-51
PDF size: 316.84 Kb.


ABSTRACT

Background: Ascending aortic aneurysm disease (AAAD) shows a low frequency, heterogeneous behavior, high risk of rupture, dissection and mortality, making elective surgery necessary. Several procedures have been developed, and the Bentall technique is considered as the reference standard. The objective was to describe the hospital mortality of AAAD surgically treated using the Bentall procedure.
Methods: We carried out a descriptive study. Included were 23 patients with AAAD who were operated on between March 1, 2005 and September 30, 2008 at our hospital. Data were obtained from clinic files, and descriptive statistics were selected for analysis.
Results: The study population was comprised of 23 patients with an average age of 46 years; 83% were males. Etiology was nonspecific median degeneration with valve implication in 43%, bivalve aorta in 22%, Marfan’s syndrome, Turner’s syndrome and poststenotic aneurysms each represented 9%, and Takayasu disease and ankylosing spondylitis 4% each. Associated heart disease was reported in six (26%) patients as follows: aortic coarctation (2), ischemic cardiopathy (1), atrial septal defect (1), severe mitral insufficiency (1) and subaortic membrane (1). Procedures carried out were Bentall surgery in 20 (87%) patients and aortoplasty with valve prosthesis in three (13%) patients. Complications reported were abnormal bleeding with mediastinal exploration (17%), nosocomial pneumonia (13%), arrhythmia (13%), septic shock (9%). Mortality was reported in three (13%) patients due to septic shock and ventricular fibrillation.
Conclusions: Surgical mortality with the Bentall procedure is similar to published results by other specialized centers. Events related to the basic aortic pathology, surgical technique, aortic valve prosthesis and left ventricular dysfunction encourage long-term studies with follow-up.


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