[Modified bentall operation using composite graft without resection of aortic valve]

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Aortic dissection and spontaneous aortic rupture are life-threatening conditions requiring complex surgical intervention.
• The Bentall operation is a standard procedure for aortic root and ascending aorta pathologies.
• Marfan syndrome is a genetic disorder that can affect the aorta, increasing dissection risk.

Observation:

• Two cases are presented: a 27-year-old male with aortic dissection (Stanford A), aortic regurgitation, annulo-aortic ectasia, and Marfan syndrome, and a 63-year-old male with spontaneous aortic rupture and aortic regurgitation.
• Both patients underwent a modified Bentall operation with composite graft and total arch replacement.

Findings:

• The modified Bentall procedure, featuring a proximal suture modification without aortic valve resection (intravalvular implantation), facilitated good recovery in the first patient, notably without requiring blood transfusion.
• The second patient with spontaneous aortic rupture also had a favorable outcome following the same surgical approach.

Implications:

• This modified surgical technique may offer improved recovery and reduced transfusion needs in complex aortic surgeries.
• Prompt surgical intervention is crucial for survival in cases of spontaneous aortic rupture.
• Further research into modified Bentall techniques could refine treatment strategies for aortic diseases.