The Left Main Complication of the Bentall’s Procedure

Anastasius, Malcolm; Hillis, Graham S.; Yiannikas, John

doi:10.4021/cr285w

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Over time, the need for reoperation has decreased thanks to modifications 3 . However, despite these developments, several possible complications, including coronary dissection, thromboembolism, major bleeding, infection, and ostial coronary stenosis remain a concern 3,[6][7][8] . The complications after the Bentall procedure such as coronary ostial stenosis are hypothesized to be due to suture techniques, Gelatin-resorcin-formaldehydeglutaraldehyde (GRF) glue, and instrumentation during the procedure 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Anastasius et al discuss a case similar to ours where such a complication was encountered even though they had used sutures to secure the anastomosis. 6 The treatment options in patients with coronary artery stenosis post-Bentall procedure include Coronary Artery Bypass Graft (CABG) and PCI intervention. Although CABG is the preferred treatment of choice, our patient had a high operative risk score hence revascularization was performed via highrisk PCI.…”

Section: Discussionmentioning

confidence: 99%

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Left Main Coronary Artery Stenosis following Bentall Procedure: A case report.

Hameed

John

Tahirkheli

et al. 2022

Pak. j. Cardio vas. int. (print/Online)

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Since its introduction, Bentall procedure has remained the standard of care for management of ascending aortic aneurysms with associated aortic valve pathologies. It involves replacement of aortic root, ascending aorta and the aortic valve, using a hybrid vascular graft with built in valves. The openings of the main coronary arteries are then rejoined with the graft. The procedure has satisfactory long term survival rate. However, there are some complications including graft infection, stroke from dislodged plaques and coronary insufficiency due to kinking of the reconnected main coronary arteries. Here, we report a rare and life-threatening complication following Bentall procedure. A 76-year-old female developed left main stenosis following Bentall procedure, successfully treated with percutaneous coronary intervention (PCI). We discuss various etiologies and treatment options for this complication. We recommend routine surveillance with coronary angiography at six months post Bentall.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Left Main Coronary Artery Stenosis following Bentall Procedure: A case report.

Hameed

John

Tahirkheli

et al. 2022

Pak. j. Cardio vas. int. (print/Online)

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“…We describe the first reported case of RCA dissection after the Bentall procedure. We think that coronary artery dissection in our case was probably related to either mechanical injury during excision and reimplantation of the coronary buttons or from instrumentation at the time of administration of cardioplegics into the coronary arteries [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Intervention for Iatrogenic Right Coronary Artery Dissection Post Bentall Procedure: A Case Report and Minireview

Saleem

Syed

Changal

et al. 2018

Case Reports in Cardiology

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Iatrogenic coronary artery dissection is a potentially life-threatening complication of cardiovascular interventions. The optimal management of iatrogenic coronary artery dissection is not clear; however, both conservative management and percutaneous or surgical revascularization have been performed depending on the patient's clinical status and the extent of dissection. We present the first reported case of right coronary artery dissection after Bentall procedure performed for ascending aortic aneurysm. Urgent percutaneous intervention using adjunctive coronary imaging was performed with excellent clinical recovery. In this article, we highlight coronary artery dissection after Bentall procedure as a possible complication, provide an insight into various options in its management, and review published data on iatrogenic coronary artery dissection. We also discuss the challenges in percutaneous treatment of coronary artery dissection with special focus on intracoronary imaging for accurate diagnosis and guidance in the management of this complex lesion.

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“…Reimplantation can be complicated by damage to the coronary buttons, coronary occlusion or malperfusion, and bleeding. The potential catastrophic complications of coronary reimplantation after ARR can occur in the immediate postoperative period [4,5] or in the weeks and months following the operation [6][7][8][9]. In the present study, we describe our experience performing ARR with an experimental polyester graft featuring prefabricated coronary branches in an effort to prevent complications.…”

Section: Introductionmentioning

confidence: 99%

Aortic Root Reconstruction with a New Dacron Graft Featuring Prefabricated Coronary Side Branches

Calcaterra

Jazayeri

Turek

et al. 2017

Aorta

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Background: Coronary button reimplantation can represent a technical challenge of aortic root reconstruction that can be associated with significant morbidity and mortality. With the goal of simplifying coronary reimplantation and reducing the incidence of related complications, we designed a new Dacron graft with prefabricated coronary branches to minimize coronary artery mobilization and prevent the potential mechanical complications of reattachment to the body of the graft. Methods: Between June 2010 and May 2012, we implanted the graft in eight patients (six males, two females) ranging in age from 42-68 years (mean, 54 years). Six procedures were modified Bentall reconstructions, and two procedures were valvesparing root replacements using the reimplantation technique. Results: There were no complications and no morbidity or mortality related to coronary reattachment. All patients were alive and doing well at a mean follow-up of 26 months (range, 17-38 months). At an extended mean follow-up of 42 months (range, 25-56 months), one patient died of stroke-related complications. No radiologic or clinical evidence of impairment of coronary perfusion was identified in any patient. Conclusions: The use of this new graft model may simplify the technique of root reconstruction and potentially lower the incidence of mechanical complications related to coronary button reimplantation.

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The Left Main Complication of the Bentall’s Procedure

Abstract: We present two interesting cases of critical left main stenosis following the Bentall’s procedure, with each case having a different outcome. There will also be brief discussion of the treatment for this complication.

Cited by 4 publications

References 5 publications

Left Main Coronary Artery Stenosis following Bentall Procedure: A case report.

Left Main Coronary Artery Stenosis following Bentall Procedure: A case report.

Percutaneous Coronary Intervention for Iatrogenic Right Coronary Artery Dissection Post Bentall Procedure: A Case Report and Minireview

Aortic Root Reconstruction with a New Dacron Graft Featuring Prefabricated Coronary Side Branches

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