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العنوان
Bentall Operation, Early and Short Term Postoperative Outcomes/
المؤلف
Mohammed ,Mostafa Abdel Salam
هيئة الاعداد
باحث / مصطفى عبدالسلام محمد
مشرف / ولاء احمد صابر
مشرف / مصطفى عبد العظيم عبد الجواد
مشرف / سعيد رفعت العاصى
مشرف / محمد عبد الرحمن بدوى
تاريخ النشر
2017
عدد الصفحات
238.p:
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
جراحة
تاريخ الإجازة
1/1/2017
مكان الإجازة
جامعة عين شمس - كلية الطب - Cardiothoracic Surgery
الفهرس
Only 14 pages are availabe for public view

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Abstract

Background: Aortic root replacement (Bentall operation) is the treatment of choice for aortic root aneurysm or dissection with a diseased valve.
Objective: The aim of the current study was to evaluate early and short term outcomes of Bentall operation in aortic root aneurysm or dissection.
Methods: from January 2010 to December 2013, 77 consecutive patients (56 (72.7%) men and 22 (27.3%) women, age 46.88±13.06 years) underwent Bentall operation. Of these 77 patients, 53 (68.8%) of aortic root/ascending ectasia /aneurysm (R/As A) were treated for degenerative/atherosclerotic, congenital and rheumatic root / ascending aortic aneurysm (40 (75.5%) men and 13 (24.5%) women, age, 45.92±13.57 years) and 24 (31.2%) of acute type A aortic dissection (ADA) (16 (66.7%) men and 8 (33.3%) women, age, 49.00±11.85 years).
Results: The overall 30-day mortality after Bentall operation was 13% (n = 10). It was 9.4% (n = 5) after elective aneurysm replacement compared to 20.8% (n = 5) after urgent ̸ emergency repair for acute type A aortic dissection with P value = 0.302.
Statistically significant univariate predictors of 30-day mortality were; Female gender (P value= 0.013), hyperlipidemia (P value= 0.022), COPD (P value= 0.002), DM (P value= 0.002), tobacco Smoking (P value= 0.020), renal dysfunction (P value= 0.036), NYHA class IV (P value= 0.011), the lower preoperative mean values of EF < 50% (P value= 0.003) , the higher mean values of aortic diameter (P value= 0.001), prolonged operation time (P value= 0.004), prolonged CPB time (P value= 0.000), prolonged cross clamp time (P value= 0.001) and prolonged ventilation time (P value= 0.001).
Conclusion: The early postoperative mortality of our study was higher in patients with type A aortic dissection than in patients with aortic root ̸ ascending aneurysm and both groups results were more or less matched with results from similar international studies. There is a significant reduction in LVEDD and LVESD between preoperative and early postoperative and between early postoperative and at follow up in both groups.
Key word: Aortic aneurysm, aortic dissection and Bentall operation.