Clinical Experience with the Bentall Procedure: 28 Years.
10.3349/ymj.2012.53.5.915
- Author:
Hyun Chel JOO
1
;
Byung Chul CHANG
;
Young Nam YOUN
;
Kyung Jong YOO
;
Sak LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea. sak911@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Annuloaortic ectasia;
marfan syndrome;
bentall procedure
- MeSH:
Aneurysm;
Aorta;
Aorta, Thoracic;
Aortic Diseases;
Aortic Valve;
Blood Vessel Prosthesis;
Follow-Up Studies;
Freedom;
Humans;
Marfan Syndrome;
Mortality;
Reoperation;
Retrospective Studies;
Survival Rate
- From:Yonsei Medical Journal
2012;53(5):915-923
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We retrospectively analyzed 28 years of experience with the Bentall procedure in patients with aortic valve, aortic root, and ascending aortic disease. MATERIALS AND METHODS: 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%). RESULTS: 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. CONCLUSION: 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.