Influence of Bentall Procedure on Left Ventricular Function

Abstract Objective: To evaluate the influence of Bentall procedure on left ventricular function and condition on long-term follow-up. Methods: Seventy-three consecutive patients who underwent an aortic root and ascending aorta replacement with composite valve button Bentall or flanged Bentall technique, from January 2007 to November 2018, were included in this retrospective study. Results: Postoperative left ventricular ejection fraction significantly increased (52.14±11.38 vs. 56.79±11.36; P=0.041), left ventricular end-systolic diameter significantly reduced (38.25±9.31 mm vs. 34.17±9.15 mm; P=0.027), left ventricular end-diastolic diameter significantly reduced (56.42±9.72 mm vs. 51.58±9.03 mm; P=0.01), and left atrial diameter significantly reduced (45.33±12.77 mm vs. 39.25±12.41 mm; P=0.01), compared to preoperative values. Our long-term survival results are comparable with previous studies in which survival rates in 5 years and 10 years were 83.5% and 69.8%, respectively. In comparing patients according to their New York Heart Association (NYHA) functional class, it was shown that their postoperative functional capacity was improved during the follow-up period (2.1±0.56 vs. 1.2±0.42; P=0.001). Conclusion: The Bentall procedure significantly improved the left ventricular systolic function and condition and decreased the left ventricular end-systolic and end-diastolic diameters and the left atrial diameter on long-term follow-up, based on the transthoracic echocardiography. Bentall procedure can be performed with acceptable mortality and morbidity rates on long-term follow-up.摘要 研究目的：评估Bentall手术（Bentall procedure）对左心室功能及状态的长期随访影响。研究方法：本回顾性研究纳入2007年1月至2018年11月期间，接受复合瓣膜纽扣式Bentall技术或带翼Bentall技术行主动脉根部及升主动脉置换术的73例连续性患者。研究结果：与术前相比，术后左心室射血分数显著升高（52.14±11.38 vs. 56.79±11.36；P=0.041），左心室收缩末期内径显著缩小（38.25±9.31 mm vs. 34.17±9.15 mm；P=0.027），左心室舒张末期内径显著缩小（56.42±9.72 mm vs. 51.58±9.03 mm；P=0.01），左心房内径显著缩小（45.33±12.77 mm vs. 39.25±12.41 mm；P=0.01）。本研究的长期生存结果与既往研究相当，后者的5年、10年生存率分别为83.5%和69.8%。按纽约心脏协会（New York Heart Association, NYHA）功能分级对患者进行分组比较后发现，随访期间患者的术后心功能得到改善（2.1±0.56 vs. 1.2±0.42；P=0.001）。研究结论：基于经胸超声心动图结果，长期随访显示Bentall手术（Bentall procedure）可显著改善左心室收缩功能及状态，缩小左心室收缩末期、舒张末期内径与左心房内径。在长期随访中，Bentall手术的死亡率与并发症发生率处于可接受水平。