The bentall procedure an attractive option for the. Since then, mechanical vales have been generally used. Comparing outcomes between valvesparing root replacement. Alternatively, you can download the file locally and open with any standalone pdf reader. Data were obtained from clinic files, and descriptive statistics were selected for analysis. Nonetheless, there is a paucity of data on outcomes of the. The durations of cardiopulmonary bypass and aortic crossclamping, the rate of postoperative complications, surgical effectiveness, cardiac function parameters left ventricular end diastolic.
The bentall procedure is a type of cardiac surgery involving composite graft replacement of the aortic valve, aortic root, and ascending aorta, with reimplantation of the coronary arteries into the graft. Wartono,md harapan kita national cardiovascular centre harapan kita jakarta 2016 2. Bentall 42 27 18 root sparing 58 73 82 with avr 36 47 39 hemiarch 44 56 28 arch replacement 7. We present the main indications, general and special technical aspects of the procedure, and results according to literature data and own. Hugh henry bentall was educated at seaford college and studied medicine at st bartholomews hospital in london.
The bentall operation is a favorable technique of aortic root replacement and can be applied to most cases in adult aortic root pathology. The aim of this study is to evaluate the role of ct angiography cta in the postoperative followup after bentall operation ascending aorta and aortic valve repair with coornary. We present a report on reinforcement of the proximal anastomosis during the bentall operation. The bentall procedure the journal of thoracic and cardiovascular. The aortic root includes the annulus tough, fibrous ring. The bentall surgery is indicated for the following conditions of the aorta.
The composite graft was placed at the intraannular position inside of the preserved leaflets. In 109 contrast, it is widely held that reoperative aortic root replacement with a bentall procedure is a 110 complex and challenging operation. A bentall procedure is a type of surgical procedure usually performed as a part of open heart surgeries that concerns the aorta, the largest artery of the. If the indication for surgery was valvular disease, the aortic root was replaced if the ascending aorta exceeded 4 to 4. Multimedia manual of cardiothoracic surgery, jan 2014 marco di eusanio, giacomo murana, mariano cefarelli. Secondary endpoint was freedom from major adverse events maes, including death, aorticvalve reoperation, major haemorrhage, cerebrovascular events, aortic valve regurgitation or dysfunctionmoderate.
Minibentall procedure encompasses aortic root and ascending aortic replacement with reimplantation. Bentall procedure using cryopreserved valved aortic. We retrospectively analyzed 25 years of experiences with the button bentall procedure in patients with aortic root pathologies. Comparing outcomes between valvesparing root replacement and. In case of difficult coronary mobilization such as extreme aortic dilatation or reoperation, the cabrol technique was preferred 7 patients, 2. Several reports of favourable longterm outcomes, including survival and echocardiographic benefits, have for decades been reported for patients after bentall surgery 4345. Valve sparing rootreplacement vsrr techniques have gained popularity, avoiding. Aortic regurgitation leaking of the aortic valve marfans syndrome genetic disease that causes aortic wall weakness.
In 110 contrast, it is widely held that reoperative aortic root replacement with a bentall procedure is a 111 complex and challenging operation. Typically the native aortic root and aortic valve are replaced with a composite graft that comprises both ascending aortic and aortic valve grafts, to which the coron. Hugh henry bentall was educated at seaford college and studied. Bentall procedure recovery time varies from one patient to the other. In aortic root surgery, bentall procedure has been considered the procedure of choice. Since the initial description of the composite valvegraft technique for repair of aneurysms of the aortic root and ascending aorta with associated aortic valve. In 1994, we abandoned the original bentall procedure and began the button technique known also as modified bentall procedure 3, 4. A3 elective valve sparing procedure for isolated valve regurgitation 5 b1 elective bentall procedure for aortic aneurysm 23 b2 urgent bentall proceduret for aortic dissection 10 b3. Data of patients who underwent bentall operation and vsrr.
Bentall rowlands has been a worldwide leader in the grain storage industry for nearly 200 years. Original article bentall procedure and valvesparing. They are replaced with a dacron synthetic polyester fabric tube that has a mechanical aortic valve sewn to one end. Immediately after the procedure, you can expect to spend a day or two in the intensive care unit icu. Patient engagement patient education 2,5,267 views. Modified bentall procedure with a rapid deployment valve. Revisiting bentall procedure for type a aortic dissection dicky a. They are replaced with a dacron synthetic polyester. Longterm survival after the bentall procedure in 206. A bentall procedure is a cardiac surgery operation involving composite graft replacement of the aortic valve, aortic root and ascending. Hospital mortality article pdf available in cirugia y cirujanos 781. The aim of this study is to evaluate the role of ct angiography cta in the postoperative followup after bentall operation ascending aorta and aortic valve repair with coornary reimplantation. Alternatively, you can also download the pdf file directly to your computer, from where it can be opened using a pdf reader. The recognition that patients with a bicuspid aortic valve bav are at risk for aortarelated death rupture or dissection has favored composite aortic root replacement in bav patients who.
Mdct evaluation of aortic root surgical complications. The treatment of recurrent aortic prosthetic detachment with modified bentall procedure. The left ventricular function was moderately depressed and the aortic root was measured at 5. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader. Ct is the primary imaging modality used after aortic root repair. In 110 contrast, it is widely held that reoperative aortic root replacement with a bentall procedure is a. Interrupted horizontal mattress sutures 20 polyestel reinforced with pledgets were placed.
Followup after ascending aorta repair with bentall technique. Your aortas role is to carry oxygenrich blood from your heart to the rest of your body. Pdf the modified bentall procedure for aortic root. The study population was comprised of 23 patients with an average age. These are clear indications for the need for urgent surgery. Use of the bentall procedure and valved homografts for aortic root replacement including the ascending aorta has been reported by several authors. Typically the native aortic root and aortic valve are replaced with a composite graft that comprises both ascending. The grafts often used for the bentall procedure are composite grafts, cryopreserved homografts, autologous pulmonary valves, and stentless valves. The bentall procedure is a surgery performed to correct defects of the aorta. Fortyeight patients underwent valvesparing procedures valvesparing group, and 72 patients underwent the bentall procedure bentall group. This technique could be extremely beneficial for all patients requiring a classical bentall procedure, but with specific indications for a biological solution. Modified bentallde bono procedure using a composite graft. Failed aortic bioprosthesis replacement requires a redo aortic root replacement that is associated with significant morbidity and mortality.
The button bentall procedure operative techniques in thoracic. With global suppliers and such a wide selection of products, bentall rowlands has all the resources and expertise to provide you with a grain storage system that meets your. A simple modified bentall technique for surgical reconstruction of the. During the procedure, the mean size of the implanted aortic valve. Bentall procedure definition of bentall procedure by. The bentall procedure, since its inception, has been a powerful method for treating patients both electively and emergently for aortic root aneurysms.
How to replace a bioprosthetic aortic valve within the. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. It involves replacement of the root and aortic valve with a graft and either a biological or mechanical valve prosthesis. Clinical experience with the bentall procedure yonsei medical. It actually depends on the overall health of the patient and how successfully the procedure was conducted. Included were 23 patients with aaad who were operated on between march 1, 2005 and september 30, 2008 at our hospital. In particular the work is focused in evaluation of early and late postsurgical complications. The procedure involves the replacement of the aortic root base of the aorta and valve three flaps that. Although the bentall procedure is a durable operation, with a low ascending aorta and valve reoperation rate, the replacement of the aortic valve with a. The bentall procedure with a biological valved conduit. In most of the patients in this series, the indication for a bentall procedure was the presence of aortic valve dysfunction severe enough to warrant aortic valve replacement. Data were obtained from clinical files, and descriptive statistics were selected for analysis.
The bentall procedure has led the way for the develop ment of other techniques for root replacement, such as aortic valvesparing procedures. Minibentall procedure annals of cardiothoracic surgery. Distinction of normal findings from postoperative complications is imperative and requires. The aortic wall was excised with a 5mm remnant, and aortic valve leaflets were preserved. Aortic root replacement with a composite valvegraft is a surgical treatment for aortic root aneurysms with a diseased aortic valve. Nonetheless, there is a paucity of data on outcomes of the 111 bentall procedure in the setting of previous cardiac surgery, with most available evidence 112 derived from small singlecenter cohorts 816. Bentall procedure versus valvesparing ascending aortic. Between 1988 and 20, a total of 147 patients underwent the bentall procedure by. To download the pdf, click the download link below. Marfan syndrome mfs is a systemic disorder of connective tissue inherited in an autosomal dominant fashion and caused by mutations in the gene encoding fibrillin1, an extracellular. Dec 03, 2014 in this video, the authors present their technique for aortic root replacement using a freestyle aortic root prosthesis and a dacron graft, thus achieving a biological bentall. Bentall procedure versus valvesparing ascending aortic replacement in the treatment of aortic dissection involving the aortic root. Modification of the bentall operation using the proximal.
This article is from yonsei medical journal, volume 53. Aortic root replacement in elderly patients valve sparing, wheat procedure or bentall e. Aug, 2008 we present a report on reinforcement of the proximal anastomosis during the bentall operation. However, late survival was significantly lower in the bentall group on logrank analysis, which we believe is because of our preferential use of this procedure for higher risk patients. Chimney bentall procedure in the small aortic root after. Modified bentall procedure with a rapid deployment valve in. A computed tomography and mri were performed to assess the ascending aorta and aortic root, as well as left and right ventricular function.
Pdf the bentall procedure in ascending aortic aneurysm. This is corroborated by the demonstration of substantial statistical heterogeneity. Early outcomes of the bentall procedure after previous. Aortic root replacement bentalls procedure sydney heart. The bentall procedure is a type of cardiac surgery involving composite graft replacement of the aortic valve, aortic root, and ascending aorta, with reimplantation of the coronary arteries into. This is a pdf file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the. Composite graft surgery bentall procedure in this surgery, the dilated enlarged part of the aorta and aortic valve are removed. The aortic root is the section of the aorta the large artery leaving the heart that is attached to the heart. Ascending aorta aneurysm disease aaad is characterized by its low frequency, heterogeneity and risk of rupture and dissection, complications that determine the high mortality of 94 to 100%.
Followup after ascending aorta repair with bentall. This can involve replacing some defective parts of the aorta such as the valve or the upper part called as the ascending aorta, with a graft. On july 20, 2015, a systematic literature search was conducted in embase, medline, the cochrane collaboration, and web of science. Apr 03, 2017 a computed tomography and mri were performed to assess the ascending aorta and aortic root, as well as left and right ventricular function. The choice between a biological or mechanical valve is complex, and patients should discuss. The bentall procedure in ascending aortic aneurysm. The aortic wall was excised with a 5mm remnant, and aortic valve leaflets. For years, this technique became the practice standard for surgical treatment of dysfunctions of the aortic valve, root and ascending aorta 3 5. The bentall procedure an attractive option for the aortic.
Bentall procedure surgical heart treatment, find cardiologists. A bentall procedure is surgery to help correct problems with your aorta. An aneurysm is an abnormal bulge in the wall of a blood vessel. The vast majority of bentall procedures involve replacement of the aortic root with a mechanical valved conduit.
This operation is used to treat combined disease of the aortic valve and ascending aorta, including lesions associated with marfan syndrome. The procedure involves the replacement of the aortic root base of the aorta and valve three flaps that ensure the oneway flow of blood from the heart to the aorta, and reimplantation of the coronary arteries that branch out from the ascending aorta. Bentall procedure in a highly heterogeneous patient population with respect to patient age, indication for operation, comorbidities, and concomitant procedures. We retrospectively analyzed 28 years of experience with the bentall procedure in. Surgical management of aortic root dilatation with. Ascending aorta aneurysm disease aaad is characterized by its low frequency, heterogeneity and risk of rupture and. The procedure involves the use of a graft to replace the diseased vessel, and reimplantation of the coronary arteries arising. A mini bentall procedure is an aortic root replacement with reconstruction of coronary buttons, performed via a minimally invasive approach. The evidence in a bentall procedure with valsalva graft.
Results of two cases by chong zhang, yiming ni, liping shi and tao jin download pdf 119 kb. Turner md fcssa instituto nacional del torax clinica santa maria santiago chile. The chimney bentall procedure using a selfassembled valve composite graft has been performed in 24 patients with a small aortic root or annulus after previous valve replacement in our centre. Pdf the modified bentall procedure for aortic root replacement. Bentall procedure is performed for the repair of ascending aortic root lesions. Biological versus mechanical bentall procedure for aortic.
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