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Modified button-Bentall operation for aortic root replacement: the miniskirt technique
G Michielon1, L Salvador, U Da Col
1Cardiac Surgery Department Ospedale S. Maria dei Battuti, Treviso, Italy. guido.michielon@tin.it
The Annals of Thoracic Surgery
|September 22, 2001
Summary
The modified button-Bentall operation offers excellent midterm survival and reoperation freedom for aortic root replacement. This technique accommodates various prosthetic valves, demonstrating low mortality and good long-term outcomes in patients with complex aortic conditions.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- The modified button-Bentall operation (modified-bB) is a surgical technique for aortic root replacement.
- It is designed to accommodate various prosthetic valves in composite conduit procedures.
Purpose of the Study:
- To evaluate the midterm results of the modified button-Bentall operation.
- To assess its safety and efficacy in composite conduit aortic root replacement.
Main Methods:
- A total of 135 patients underwent the modified-bB procedure between 1991 and 2000 for various aortic conditions.
- Prosthetic valves (bioprostheses or mechanical) were implanted in a composite conduit.
- Coronary arteries were reimplanted using the button technique.
Main Results:
- The 30-day mortality was 5.18%, with 5.9% requiring revision for anastomosis leakage.
- Nine-year survival was 91.8%, with 88.1% freedom from reoperation.
- Previous operation and emergency surgery were independent predictors of hospital mortality.
Conclusions:
- The modified button-Bentall operation demonstrates low mortality and excellent midterm survival and reoperation freedom.
- Advantages include accommodating any prosthetic valve, reduced coronary button tension, and tailored prosthesis selection.