Artificial vascular ascending aorta with aortic valve replacement surgery in the treatment of ascending aortic aneurysm with retrograde coronary sinus perfusion in beating heart

Abstract

Objective To summarize the experience and myocardial protection of ascending aortic aneurysm treatment using Bentall operation with retrograde coronary sinus perfusion in beating heart. Methods A total of 56 cases of ascending aortic aneurysm were treated by surgery with beating heart or cardioplegia. The levels of tropninI, creatine kinase isoenzyme MB (CK-MB) and malondialdehyde (MDA) at different time points were detected. Statisticalanalysis of data using the statistical product and service solutions 10.0 software. Results TropninⅠ serum concentration of both group were significantly increased at 15 min after aortic opening and all time points afterwards (P<0.01), but the beating-heart group was significantly lower than that of cardioplegia group (P<0.01); CK-MB concentration of both group were significantly increased at 15 min after aortic opening and all time points afterwards (P<0.01), but the levels of beating-heart group were significantly lower than the cardioplegia group at 15 min after aortic opening, 2 hour and 1 day after surgery (P<0.01, P<0.05). When the bypass machine was turned off, the myocardial MDA concentration of the beating-heart group was significantly lower in the cardioplegia group (P<0.01). There was no significant difference in the operation time, cardiopulmonary bypass time, postoperative bleeding volume and prosthetic valve circumferential leakage between the two groups. Conclusion Bentall operation can be carried out with retrograde coronary sinus perfusion in beating heart, which demonstrated better myocardial protective effect. Key words: Retrograde coronary sinus perfusion in beating heart; Bentall operation; Ascending aortic aneurysm; Myocardial protection