AORTIC ROOT REPLACEMENT (BENTALL PROCEDURE): SINGLE SURGEON EXPERIENCE

Year 2003, Volume: 16 Issue: 1, 27 - 31, 03.12.2016

Sinan Arsan

Abstract

Objective: This study was prompted in part by a theory based on the impression that aortic root replacement (ARR) in the elderly has a high morbidity and mortality.
Methods : Retrospective analysis of 58 patients following ARR was carried out between 1996- 2002. All the operations were performed by the author-an experienced surgeon. The choice of first assistant was based solely on availability; certified cardiovascular surgeon or experienced registered nurse. Patients were divided into two groups: group 1 patients were < 70 years of age and group 2 were > 70 years of age. The distribution of patients was similar in each group, as was the surgical strategy and concomitant surgical procedures.
Results : The hospital mortality was 3 (8.3%) for group 1 patients and 2 (9.1%) for group 2 patients. The mortality and morbidity rates were dependent of the patient NYHA status, as were the cardiopulmonary bypass time, the aortic cross clamp time, blood loss, adjusted blood transfusion volume and concomitant procedures.
Conclusion : ARR in the elderly is safe, the long term result is good and it remains the treatment of choice unless there is an absolute contraindication.
Key Words: Aort, Aortic root, Aort valve replacement, Mitral valve replacement, Coronary artery bypass grafting

AORTIC ROOT REPLACEMENT (BENTALL PROCEDURE): SINGLE SURGEON EXPERIENCE

Abstract

Objective: This study was prompted in part by a theory based on the impression that aortic root replacement (ARR) in the elderly has a high morbidity and mortality.
Methods : Retrospective analysis of 58 patients following ARR was carried out between 1996- 2002. All the operations were performed by the author-an experienced surgeon. The choice of first assistant was based solely on availability; certified cardiovascular surgeon or experienced registered nurse. Patients were divided into two groups: group 1 patients were < 70 years of age and group 2 were > 70 years of age. The distribution of patients was similar in each group, as was the surgical strategy and concomitant surgical procedures.
Results : The hospital mortality was 3 (8.3%) for group 1 patients and 2 (9.1%) for group 2 patients. The mortality and morbidity rates were dependent of the patient NYHA status, as were the cardiopulmonary bypass time, the aortic cross clamp time, blood loss, adjusted blood transfusion volume and concomitant procedures.
Conclusion : ARR in the elderly is safe, the long term result is good and it remains the treatment of choice unless there is an absolute contraindication.

Keywords

Aort, Aortic root, Aort valve replacement, Mitral valve replacement, Coronary artery bypass grafting

References

• Michielon Q, Salvador L, Da Col U, Valfre C. Modifies button-Bentall operation for aortic root replacement : the miniskirt technique. Ann Thorac Surg 2001:72:1059-1064.
• Apaydin AZ, Posacioglu fl, Islamoglu V, Yagdi T, Buket S, Durmaz I. Analysis of perioperative risk factors in mortality and morbidity after modified Bentall operation. Jpn Heart J 2002;43:151-157.
• Prifti E, Bonacchi M, Prati O, et al. Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Ben tail's technique. Eur J Cardiothorac Surg 2002;21:15-21.
• Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax 1968:23:338-339.
• Alexion C, Langley SM, Charlesworth P, Haw MP, Livesey SA, Monro JL. Aortic root replacement in patients with Marfan's syndrome.the Southampton experience. Ann Thorac Surg 2001;72:1502-1507.
• Hiederhauser U, Kunzli A, Qenoni M, Vogt P, Lâchât M, Turina M. Composite graft replacement of the aortic root: long term results, incidence of reoperations. Thorac Cardiovasc Surg 1999;4 7:31 7-321.
• Ogus HT, Cicek S, Isik O. Selective management of high risk patients with an ascending aortic dilatation during aortic valve replacement. J Cardiovasc Surg (Torino) 2002;43:609-615.
• Hew longevity record in the United States. Stat Bull 1988:68:10-15.