Bio-Bentall手術の展望

Future Aspects of Bio-Bentall Procedure

大動脈弁輪拡張症に対する人工弁付きグラフトによるBentall手術は，1968年にBentallらにより確立された手術術式で，人工弁と人工血管をあらかじめ縫合したコンポジットグラフトにより基部置換術を行うものである1）．その後，Cabrol法2），Pieler法3），Button法（Carrel patch法4，5））などの冠状動脈再建法が発表され，遠隔成績も向上し，現在もっとも普及し標準化された

The Bentall procedures using biological valved conduit is expanding owing to the increasing incidence of aortic valve disease in the aging population and usage for young generation. The long-term durability of the biological valve including the risks of structural valve deterioration （SVD） is the major concern of the bio-Bentall procedure. Bio-Bentall in our hospital are reviewed and literature review are added. Our surgical results of long-term survival in bio-Bentall patients is acceptable compare to other study and freedom from SVD and reoperation is better than other results. There was no experience of SVD complication so far. Modification using double sewing ring technique is useful to put larger valve, keep better hemostasis, easy to do reoperation for further SVD and expect for future valve in valve situation.