Long-Term Results of Modified Bentall Procedure Using Flanged Composite Aortic Prosthesis

Abstract

Purpose: We have been using the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia in aortic root replacement procedures at our institution over the last twenty five years. Our objective was to evaluate the long-term results of aortic root replacement with this technique. Methods: A total of 73 patients from January 1984 to August 2010 were included in this study. The median age was 52.7 ± 14.4 years (range 28-80 years). There were 48 male and 25 female patients. 44 patients (60.3%) had annuloaortic ectasia, and 15 patients (20.5%) had acute type A aortic dissection. Marfan syndrome was recognized in 12 patients (16.5%). Results: The early mortality rate was 5.5% (n = 4). Causes of death were multiple organ failures in two patients and sepsis in another two patients. The actuarial survival rate was 84.2% at 5 years, 64.3% at 15 years and 51.9% at 25 years. Only one patient with aortitis needed a reoperation because of coronary pseudoaneurysm after 23 years from the previous operation. Conclusion: This modified Bentall procedure is reliable and safe, with superior long-term survival and a low rate of aortic reoperation.Keywords: bentall procedure, aortic root replacement, carrel button technique ite aortic root replacement with direct coronary artery implantation was reported with excellent results. 5-7)In our institution, we have selected the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia for the aortic root replacement since 1984, and Suzuki et al. reported modified Bentall method for aortitis previously. 8) We sought to evaluate the longterm results of aortic root replacement with this technique. Materials and Methods Patient characteristicsBetween January 1984 and August 2010, 73 patients (48 males, 25 females; mean age 52.7 ± 14.4 years 52.7 ± 14.4 years; range 28 to 80 years) underwent aortic root replacement with the valve composite flanged graft and Carrel button technique to re-attach the coronary ostia. Medical records were reviewed retrospectively for patient demographics, preoperative symptoms, preoperative echocardiographic findings, operative procedures, and survival. Follow up was obtained by office visits and/or

A marked decrease in heart rate variability in Marfan syndrome patients with confirmed FBN1 mutations

“…Nevertheless, Bentall surgery, in particular its modified version, is considered reliable and relatively safe. Therefore, long-term outcomes are rather optimistic [2,17]. In our study, we did not observe substantial differences in HRV parameters of MS patients with FBN1 mutations after surgery compared to those who did not undergo the procedure.…”

Influence of Bentall Procedure on Left Ventricular Function

“…The reported mortality rate for elective Bentall surgery ranges from 1 to 5% [17,18] . In addition, Pacini et al [15] reported a 6.9% early-term mortality rate.…”

Early and Midterm Outcomes of Valve-Sparing Aortic Root Replacement—Reimplantation Technique

“…5 6 However, valve graft conduits as described in the original Bentall-DeBono procedure have demonstrated excellent long-term survival and a low rate of aortic reoperation. 1…”

“…The use of a mechanical valve graft conduit as described in the original Bentall-DeBono procedure is reliable and safe, with excellent long-term survival and a low rate of aortic reoperation. 1 However, this approach mandates anticoagulation for mechanical valves to prevent thromboembolic complications. Also, for patients receiving bioprosthetic valve graft conduits, it is associated with a certain rate of reoperation due to degeneration of bioprosthetic valves.…”