Modified Bentall procedure: A 15-year single-center clinical experience

Abstract

Objective Bentall procedure is a standard technique for complete aortic root replacement but a huge challenge is postoperative bleeding. Many modifications have been proposed and the “button technique” is commonly used. With a 15-year experience, this study was to evaluate outcomes of this modified Bentall procedure. Methods A retrospective study was performed with all patients who underwent the Bentall procedure with a button technique between 2005 and 2020. Commercially available composite grafts were used in 38 patients and self-assembled composite graft was used in 74 patients. Safety outcome was postoperative complications and long-term outcomes included overall and reoperation-free survivals. Results Among 112 patients, the mean age was 46.3 years and 69.6% were men. Indications for the Bentall procedure were ascending aortic aneurysm and valve regurgitation (59.8%), aortic dissection (19.6%), Marfan syndrome (17%), and endocarditis (3.6%). Three patients (2.7%) died in hospital. During a median follow-up period of 42 months, 11 patients died and 7 patients required reoperation. Overall survival and reoperation-free survival were 86.1% and 83.4% at 5 years and 86.1% and 72.6% at 10 years, respectively. Conclusions The Bentall procedure with a button technique is safe and effective for aortic root replacement. Further investigations are required to improve the feasibility and effectiveness of the procedure.

Клапанозбережне Протезування Кореня Аорти: Результати Операції Девіда І

“…We did not observe this effect in our series of patients. So, the original reimplantation procedure using a straight graft does not seem to have a negative impact on the leaflets [11][12][13][14].…”

Quality of Life of Patients Treated by Valve-Sparing Aortic Root Replacement

“…This operation is technically difficult, but has many advantages. Ukrainian surgeons for many years performed Bentall operation in cases of aortic insufficiency with aneurysm of the root and ascending part of the aorta [10,11]. It is a fact of a lot of complications after Bentall operations [13].…”

Long-stay predictors in the intensive care unit after Bentall procedure: retrospective research

“…2 At the same time, due to a signifi cant number of complications associated with bleeding from the proximal anastomosis and the site of coronary artery implantation, the original technique has undergone a number of modifi cations, which allowed this procedure to be performed with a relatively lower incidence of hemorrhagic postoperative complications. [3][4][5] However, despite the modifi cation of the Bentall procedure, a number of postoperative complications still persist, such as hemodynamic instability, acute kidney injury, respiratory failure with prolonged mechanical ventilation, which can affect the length of intensive care unit (ICU) stay. 6,7 Prolonged ICU stay leads to signifi cant healthcare costs and excessive consumption of medical resources, as well as to an increase in perioperative mortality and complications.…”