Eighteen years of clinical experience with a modification of the Bentall button technique for total root replacement

Abstract

Background: We retrospectively reviewed our experience with the modified Bentall procedure and evaluated the short-and long-term results over a period of 18 years. Methods: Between 1999 and 2017, 89 patients with a mean age of 57.3±13.9 years underwent the modified Bentall operation with a slight modification for the correction of aortic root disease.Results: The operative mortality was 1.1% while the overall early mortality rate, defined as death within 30 days of initial hospitalization, was 2.2% (2/89). Logistic regression analysis revealed that increased Euroscore and aortic cross-clamp times were associated with greater likelihood for complications. The overall survival rates for the 89 patients (including deaths occurred at the initial hospitalization) were 93.0% (SE =3.0%) at 6 months, 93.0% (SE =3.0%) at 1 year, 89% (SE =5.0%) at 5 years and 73.0% (SE =5.0%) at 10, 15 and 18 years. Multiple Cox regression analysis for survival identified that increased aortic crossclamp time, increased age, having a concomitant cardiac procedure and increased NYHA Class were associated with greater hazard. Left ventricular remodeling was assessed by means of echocardiography preoperatively and 1, 3, 6 and 12 months postoperatively. Conclusions: According to our experience, the Bentall procedure is a safe procedure, provides optimal long-term survival and can still be regarded as the gold standard procedure for aortic root replacement.

A pulsatile chest mass after Bentall procedure: a case report

“…Nowadays, the "button" modification of the original Bentall procedure has been a standard operative technique and is the one most widely used for aortic root replacement as the safety and long-term efficacy have been confirmed. 14,15 In conclusion, an optimal treatment strategy should be based on a comprehensive assessment of the patient's condition. For aortic valve disease, whether to perform a single aortic valve replacement or with a simulta-neous aortic surgery for a prophylactic purpose should be carefully evaluated.…”

Long Term Outcomes of Freestyle Stentless Aortic Bioprosthesis: A Single Center Experience

“…Large studies of prosthetic aortic root replacements have reported a range of short-term mortality of 0.7% to 12% and long-term survival of 75% at 5 years to 91% at 16 years [Schachner 2005;Gelsomino 2003]. The wide range reported in these studies is partially explained by their inclusion of higher-risk patients such as urgent or emergency operations, dissections, endocarditis, redo sternotomies, previous AVR, specific genetic conditions, or older patients [Karangelis 2018]. When limited to elective operations only, mortality rates of the present study are comparable to other studies [Woldendorp 2014].…”

A Pulsatile Chest Mass After Bentall Procedure: A Case Report

“…Excision of a small cuff of surrounding aortic tissue as "coronary buttons" can considerably improve the visibility and facilitate the aortic-coronary anastomosis. Nowadays, the "button" modification of the original Bentall procedure has been a standard operative technique and is the one most widely used for aortic root replacement as the safety and long-term efficacy have been confirmed [Karangelis 2018;Westaby 2000].…”