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Modified bentall procedure using two short grafts for coronary reimplantation: long-term results.
MedLine Citation:
PMID:  22269710     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The modified Bentall procedure remains a gold standard of aortic root surgery. We present in this study the early and late outcomes of a particular modification using 2 separated grafts for the coronary reimplantation.
METHODS: From 1995 to 2009, 153 patients aged 57 ± 12 (mean ± standard deviation [SD]) underwent elective (n = 113) or urgent (n = 40) aortic root replacement with a composite mechanical valve conduit reconstruction using 2 short, separated 8-mm Dacron grafts for the coronary reimplantation and were retrospectively reviewed.
RESULTS: Aortic disease etiologies were annuloaortic ectasia (n = 108), type A aortic dissection (n = 38), aortic false aneurysm, or Valsalva aneurysm evolution after previous cardiac surgery (n = 7). The overall early mortality was 8.5% (20% for urgent procedure and 4.4% for elective procedure). For the whole group, actuarial survival at 5 and 10 years was 86.3% ± 2.78 and 73.7% ± 4.23, respectively. Among the 23 late deaths, 9 were valve-related deaths (stroke, n = 3; endocarditis, n = 1; unknown, n = 5). During the follow-up, linearized rates of major bleeding, thromboembolism, and endocarditic evolution were, respectively, 1.3 %/patient-years, 0.42 %/patient-years, and 0.22 %/patient-years. One patient presented a nonseptic false aneurysm of the right coronary anastomosis and no structural valve dysfunction has been diagnosed. In total, only 2 patients required an aortic root reoperation.
CONCLUSIONS: The modified Bentall procedure using 2 separated grafts for the coronary reimplantation is a feasible, safe, easy, and reproducible operative technique for aortic root surgery.
Authors:
Pablo Maureira; Fabrice Vanhuyse; Cécile Martin; Malik Lekehal; Jean-Pierre Carteaux; Nguyen Tran; Jean-Pierre Villemot
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  93     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  443-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardio-Vascular Surgery, University Hospital, Nancy, France; School of Surgery, Faculty of Medicine, University Henri Poincaré, Nancy, France.
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