Bentall procedure after previous aortic valve or complete root replacement: Usefulness of self-assembled aortic valve conduit

Urbanski, Paul P.; Lakew, Fitsum; Dinstak, Witold; Heinz, N.; Zacher, Michael; Irimie, Vadim; Reents, Wilko

doi:10.1016/j.jtcvs.2018.01.105

Cited by 19 publications

(22 citation statements)

References 25 publications

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“…Some large sample reports [2][3][4] show that the risk of surgery has been greatly reduced. However, performing aortic root replacement surgery again, especially for patients who have had aortic root surgery before, is still a technically challenging operation [5][6] . It is reported in the literature 7 that the mortality rate of aortic root replacement has reached 18%.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Redo Aortic Root Replacement after Cardiac Surgery

Deng¹,

Zhong²

2021

ijmsci

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[Abstract] objectives To explore the etologies, surgical methods and outcomes of redo aortic root replacement after cardiac surgery. Methods Between February 2010 and February 2020, 41 patients who had at least one previous cardiac operation received aortic root replacement surgery in our hospita, including 27 males and 14 females with an average age of 49.5±10.2 years. Indications for reoperation include: aortic sinus dilation and ascending aortic aneurysm in 20 cases (48.8%), recurrent aortic dissection in 7 cases (17.0%), aortic pseudoaneurysm in 4 cases (9.8%), prosthetic valve endocarditis in 5 cases (12.2%) and 5 cases (12.2%) had paravalvular leakage. The redo operation was a midline thoracotomy, and Bentall operation was performed. In addition, 3 cases of mitral valve replacement surgery, 4 cases of mitral valvuloplasty, 8 cases of tricuspid valvuloplasty, 4 cases of coronary artery bypass graft surgery, 3 cases of Debakey I aortic dissection patients underwent Sun’s surgery simultaneously. Results The mean cardiopulmonary bypass time was 95~302 (168.1±41.2) min, and the mean aortic crossclamp time was 45~135 (84.5±22.3) min. Six patients (14.6%) died during the postoperative hospitalization. The main causes of death were heart failure in 3 patients and septic shock in 3 patients.The follow-up time was 3~62 (30.3±15.5) months. During the follow-up period, 3 cases died, including 1 case died of septic shock and 2 cases died of cerebral hemorrhage. Conclusions Redo aortic root replacement is difficult to deal with, and the risk is high. Preoperative evaluation is required, appropriate surgical approach, adequate myocardial protection, and a complete surgical plan are essential to ensure the success of the operation.

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Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Redo Aortic Root Replacement after Cardiac Surgery

Deng¹,

Zhong²

2021

ijmsci

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“…The Bentall operation after previous aortic valve replacement or root replacement has shown good outcomes for aortic root pathology. 4 This patient required Bentall operation as well as redo-Konno operation to remove all calcifications and thrombus on the previous patch material and to place a larger prosthesis. We used a bovine pericardial patch for septoplasty.…”

Section: Discussionmentioning

confidence: 99%

Bentall and redo-Konno Operation for an Adult With Aortic Paraprosthetic Leak and Root Aneurysm

Shinkawa

Nakayama

Nishinaka

et al. 2021

World J Pediatr Congenit Heart Surg

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We report a case of Bentall and redo-Konno operation. A 39-year-old male with surgical history of Konno operation presented with hemolytic anemia and heart failure. Further evaluations revealed aortic paraprosthetic leak with moderate regurgitation, moderate biventricular outflow tract obstruction, and aortic root aneurysm. During the operation, the old Konno septoplasty patch with organized thrombus and the severely calcified right ventricular patch were replaced, and the aortic root was replaced with a larger mechanical valve in a Valsalva graft. Postoperative images showed appropriately reconstructed biventricular outflow tracts. The Bentall operation with redo-Konno was an excellent option in this situation.

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“…They stated that even in nonendocarditis patient, explanation of PAV can lead to subsequent lack of annular tissue. This will lead to harboring the “rigid sewing ring of a valve prosthesis to the tearable tissue of the left ventricular outflow tract.” 6 Hence sparing the well‐functioning aortic prosthetic valve and substituting the aorta with a vascular graft and reimplanting the coronary arteries is a valuable option.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic valve sparing aortic root replacement—A persuasive option in well‐functioning aortic valve prosthesis

Idhrees¹,

Velayudhan²,

Jacob³

2021

J Card Surg

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Objectives Only limited data is available on prosthetic valve sparing aortic root replacement after aortic valve replacement. The aim of the present study was to assess the short‐ and midterm outcomes of the patients who underwent such procedures. Methods From June 2004 to March 2018, 21 patients underwent this procedure. The mean age was 51.2 ± 10.2 years with a male predominance (85.7%). The mean time interval from aortic valve replacement to the present surgery was 10.62 years. Results One patient died in immediate postoperative period who was taken up for emergency surgery—acute type A aortic dissection. Kaplan–Meier estimates of 1, 3, and 5 year survival were 95.2% ± 0.04%, 85.7% ± 0.07% and 85.7% ± 0.07%, respectively. No cardiac or aortic reinterventions were performed during follow up with a 100% freedom from reoperation at 5 years. Fifteen patients (71.43%) had aortopathy and had borderline pathology at the time of first surgery, with all of them having a tear either in the aortic sinuses or pervious aortotomy site. Conclusion The favorable short and midterm results suggests that prosthetic valve sparing aortic root replacement is a valid option when possible. Utmost care has to be taken at the primary surgery especially in patients with aortopathy, trying to avoid the need for a second surgery.

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Bentall procedure after previous aortic valve or complete root replacement: Usefulness of self-assembled aortic valve conduit

Abstract: A self-assembled composite graft allows safe proximal fixation of the conduit in patients with destroyed aortic annulus, resulting in sufficient proximal anastomosis and a very low incidence of aorta-related reoperations.

Cited by 19 publications

References 25 publications

Clinical Analysis of Redo Aortic Root Replacement after Cardiac Surgery

Clinical Analysis of Redo Aortic Root Replacement after Cardiac Surgery

Bentall and redo-Konno Operation for an Adult With Aortic Paraprosthetic Leak and Root Aneurysm

Prosthetic valve sparing aortic root replacement—A persuasive option in well‐functioning aortic valve prosthesis

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