Clinical experience with the Bentall procedure: 28 years

• Published in: Yonsei medical journal 2012, 53(5), , pp.915-923
• Main Authors: Joo, Hyun-Chel, Chang, Byung-Chul, Youn, Young-Nam, Yoo, Kyung-Jong, Lee, Sak
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aortic Aneurysm, Thoracic - mortality; Aortic Aneurysm, Thoracic - surgery; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Female; Humans; Male; Marfan Syndrome - mortality; Marfan Syndrome - surgery; Middle Aged; Original; Retrospective Studies; Young Adult; 의학일반
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2012.53.5.915

We retrospectively analyzed 28 years of experience with the Bentall procedure in patients with aortic valve, aortic root, and ascending aortic disease. Between March 1982 and December 2010, a total of 218 patients underwent the Bentall procedure using a composite valved conduit. The "inclusion technique" was used in 30 patients (13.8%), the "open-button technique" in 181 patients (83.0%), and the Cabrol technique in 7 patients (3.2%). The early mortality rate was 5.5% (12/218). The mean follow-up duration was 108.0±81.0 months (range: 1-329 months). Seven patients required re-operation, and 1 patient required stent graft insertion at the descending thoracic aorta for progression of aortic arch or descending thoracic aortic dissection or aneurysm after the first operation, and 5 of them had Marfan syndrome. Kaplan-Meier estimated survival rates at 1, 5, 10, 20, and 25 years were 90.4%, 82.7%, 77.6%, 65.3%, and 60.3%, respectively. Freedom from reoperation rates at 1, 5, 10, 20, and 25 years were 99.0%, 98.3%, 95.5%, 90.8%, and 90.8%, respectively. In our experience, the Bentall procedure provided optimal survival with improved functional status. The disease of the aorta may progress, especially in patients with Marfan syndrome. Therefore, careful follow-up with regular computed tomography angiograms should be performed in these patients.