马凡综合征Bentall术后再发主动脉夹层的外科治疗（附4例报告）

Surgical treatment for recurrent dissection of aorta after Bentall surgery for Marfan syndrome（Appendix： A report of 4 patients）

目的 分析马凡综合征Bentall术后再发主动脉夹层的原因,总结其外科治疗经验.方法 回顾分析4例马凡综合征Bentall术后再发主动脉夹层行手术治疗的临床资料,其中行主动脉弓置换＋支架象鼻术3例、降主动脉腔内支架修复术1例.结果 全组无手术死亡.术后并发呼吸功能不全并肺部感染1例.结论 马凡综合征Bentall术后再发主动脉夹层与原发病、血压控制不良、第一次手术操作方式的选择有关,再发A型患者应行急诊手术治疗.

Objective To analyze the causes of recurrent dissection of aorta after Bentall surgery for Marfan syndrome and summarize its experience in surgical treatment.Methods Clinical data of 4 recurrent dissection of aorta patients after Bentall surgery for Marfan syndrome were analyzed retrospectively,in which,3 patients underwent aortic arch replacement and stent elephant trunk technique and 1 patient received endovascular repair with the stent for the descending aorta.Results No surgical death was observed in all patients.1 patient was concurrent with respiratory insufficiency and pulmonary infection after surgery.Conclusion Recurrent dissection of aorta after surgery for Marfan syndrome was associated with primary diseases,unfavorable control in the blood pressure and the first surgical procedure,and patients with that should undergo emergent surgery.