A simple modified Bentall technique for surgical reconstruction of the aortic root – short and long term outcomes

Journal of Cardiothoracic Surgery

Mohammad Hassan Nezafati²  Ali Shomali¹  Pouya Nezafati² 

[1] Javad Al Aemeh Hospital, Mashhad, Iran;Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

关键词: Aortic valve;    Aortic surgery;    Modification;    Aortic root replacement;   

Others  :  1230546
DOI  :  10.1186/s13019-015-0336-4

 received in 2015-04-23, accepted in 2015-10-05,  发布年份 2015

【 摘 要 】

Background

Since the first introduction of the Bentall technique, several modifications have been proposed to improve patient outcomes and decrease intra- and post-operative complications. We describe a simplified modification of the technique that tries to lessen the intra-operative time, improve homeostasis and miminize early and late complications. Our experience with the technique and short- and long-term patient outcomes are reported.

Methods

From August 1996 to October 2013, 110 consecutive patients underwent this modified technique. The procedure used Dacron composite graft with a mechanical valve (St. Jude Medical®) for aortic root replacement. To avoid intra-operative complications, no mobilization of coronary ostia was done. Additionally, the tubular aorta was kept minimally unchanged.

Results

Total bleeding after the operation was 450 ± 105 mL. The mean duration of intensive care unit and hospital stay were 2 ± 1 and 5 ± 2 days, respectively. Sixty-six patients (60 %) were discharged from the surgical intensive care unit on the first postoperative day, 34 patients (30.9 %) were discharged on the second day and ten patients (9.1 %) needed more time to stay in the intensive care unit due to haemodynamic or respiratory problems. At 5-years follow up, survival rate was 97 %. In the three deceased patients, causes of death were mediastinitis, sepsis and myocardial infarction. No operation-related complications such as anticoagulant-related hemorrhage, valve or graft thrombosis, or coronary pseudoaneurysm were occurred during follow-up.

Conclusions

The proposed modification of the Bentall technique seems to minimize late intra-operative blood loss, improves homeostasis, shortens the operation time and is associated with excellent long-term outcomes in patients undergoing composite graft replacement of the aortic root.

【 授权许可】

   
2015 Nezafati et al.

【 图 表 】

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