Short-term efficacy of improved Bentall operation with

Xianzhi WANG; Jixiang LIANG; Huan WANG; Gen ZHANG; Zhigang DENG; Dongquan HE; Cunfu MU; Wenlin ZHANG; Chunzhu XUE; Yang HE; Dianyuan LI

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Short-term efficacy of improved Bentall operation with "pericardial lining" for aortic root aneurysm

VernacularTitle:“心包内衬”改良Bentall术治疗主动脉根部瘤的短期疗效
Author: Xianzhi WANG ¹ ; Jixiang LIANG ² ; Huan WANG ¹ ; Gen ZHANG ¹ ; Zhigang DENG ³ ; Dongquan HE ⁴ ; Cunfu MU ⁴ ; Wenlin ZHANG ⁴ ; Chunzhu XUE ⁴ ; Yang HE ⁴ ; Dianyuan LI ¹
Author Information

1. Department of Cardiovascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215000, Jiangsu, P. R. China
2. he State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710000, P. R. China
3. Department of Thoracic and Cardiovascular Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, P. R. China
4. Department of Thoracic and Cardiac Surgery, The First People s Hospital of Guangyuan, Guangyuan, 628000, Sichuan, P. R. China
Publication Type:Journal Article
Keywords: Aortic root aneurysm; pericardium; Bentall operation
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1615-1620
CountryChina
Language:Chinese
Abstract: Objective To investigate the feasibility of a "pericardial lining" modified Bentall procedure for the treatment of patients with aortic root aneurysm. Methods This was a retrospective study that consecutively enrolled patients treated at the Affiliated Suzhou Hospital of Nanjing Medical University, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, and the First People's Hospital of Guangyuan from January 2023 to February 2024. Preoperative clinical data, imaging findings (including echocardiography and CT scans of the aortic root and the entire aorta), details of coronary artery management, surgical outcomes, and postoperative follow-up results were collected. All patients underwent the "pericardial lining" modified Bentall procedure: the aortic valve was replaced, and an autologous pericardial patch was divided into three equal leaflets based on the circumference of the aortic annulus measured by a valve sizer. These leaflets were then sutured to the aortic annulus. Fenestrations were created in two of the pericardial leaflets for anastomosis with the left and right coronary ostia. The pericardial leaflets were sutured to the wall of the aortic sinuses to form an integrated structure, thereby narrowing the sinus portion. A prosthetic vascular graft was anastomosed to the proximal and distal aorta, and no aortic root-to-right atrium shunt was created. Results A total of 5 patients, aged 37 to 68 years, were included. The preoperative Society of Thoracic Surgeons (STS) risk scores ranged from 2.8% to 3.9%. The diameter of the ascending aorta was 40-73 mm, the left ventricular end-diastolic diameter (LVEDD) was 45-71 mm, and the left ventricular ejection fraction (LVEF) was 47%-64%. Intraoperatively, the aortic cross-clamp time ranged from 85 to 180 min, and the cardiopulmonary bypass time ranged from 110 to 302 min. Postoperative follow-up echocardiography revealed that the ascending aortic diameter was 27-35 mm, LVEDD was 39-57 mm, and LVEF was 43%-61%. All surgeries were completed successfully with satisfactory immediate outcomes and no intraoperative complications. During the follow-up period, there was no mortality or reoperation. Conclusion For patients with aortic root aneurysm, the "pericardial lining" modified Bentall procedure yields satisfactory preliminary results, and the technique is demonstrated to be feasible.