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MINERVA CHIRURGICA

A Journal on Surgery


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Minerva Chirurgica 2017 Feb 23

DOI: 10.23736/S0026-4733.17.07293-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Effects of David Ⅰ operation in the treatment of aortic root disease combined with aortic insufficiency

Ji-Dan FAN 1, Yu-Sheng SHU 1, Xin-Min ZHOU 2, Zhao-Shun YUAN 2, Xiao-Bo LIAO 2, Wei-Ping SHI 1, Min YANG 1

Department of Cardiothoracic Surgery, Northern Jiangsu People´s Hospital, Yangzhou, Jiangsu Province, China; 2 The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China


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BACKGROUND: We compared the effects of the new David Ⅰoperation and classical Bentall operation in the treatment of aortic root disease combined with aortic insufficiency.
METHODS: A total of 60 cases of patients with aortic root disease combined with aortic insufficiency diagnosed at our hospital from January 2010 to January 2016 were analyzed retrospectively, including 32 cases of aortic root aneurysm, 18 cases of aortic dissection, 5 cases of hypertension combined with atherosclerosis, 2 cases of retrogression, 2 cases of rheumatic heart disease and 1 case of takayasu arteritis. 24 cases that underwent the David Ⅰ operation and 36 cases that underwent the Bentall operation were selected and their therapeutic effects were compared. The operation success rate, operation time, cardiopulmonary bypass time, cross-clamp time and blood infusion of both groups were compared; there were no significant differences (P>0.05).
RESULTS: Two patients in the David Ⅰgroup and 3 patients in the Bentall operation group died of multiple organ dysfunction. The LVEDd and LVEF of both groups post-operation had no difference when compared with those parameters of before operation. The diameter of the valve annulus after the operation was shorter than before the operation. The severity of valve regurgitation of both groups had no difference. However, the ratio of severe regurgitation of the David Ⅰgroup increased and the mild regurgitation decreased. The incidence rate of complications of the David Ⅰ group was significantly lower than that of the Bentall operation group. The differences were statistically significant (P<0.05).
CONCLUSIONS: Both David Ⅰ operation and Bentall operation have better short-term and long-term effects in the treatment of aortic root disease when combined with aortic insufficiency; however, David Ⅰoperation had less long-term complications.


KEY WORDS: David Ⅰoperation - Bentall operation - Aortic root disease - Aortic insufficience

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