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Modified Bentall operation: the double sewing ring technique.

Alberto Albertini1, Andrea Dell'Amore, Claudio Zussa

  • 1Department Cardiovascular Surgery, Villa Maria Cecilia Hospital, Via Corriera 1, Cotignola, Lugo (RA), Italy.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|September 4, 2007
PubMed
Summary

This study presents a modified biological Bentall procedure for aortic root replacement, simplifying future reoperations. The technique facilitates easier bioprosthesis exchange, reducing complexity for patients avoiding lifelong anticoagulation.

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Area of Science:

  • Cardiovascular Surgery
  • Bioprosthetic Devices
  • Aortic Root Replacement

Background:

  • The Bentall-DeBono operation is standard for aortic root replacement.
  • Biological Bentall procedures offer an alternative for patients avoiding anticoagulation.
  • Bioprosthetic degeneration necessitates reoperation, which can be complex.

Purpose of the Study:

  • To present a modified biological Bentall technique.
  • To simplify reoperations for bioprosthetic degeneration.
  • To assess the feasibility and safety of the modified technique.

Main Methods:

  • A modified biological Bentall procedure was developed using a vascular graft with two distinct sewing rings.
  • One ring secures the bioprosthesis to the graft; the second anchors the graft to the aortic annulus.
  • Reoperation involves removing the bioprosthesis via the first ring, allowing reuse for new prosthesis fixation.

Main Results:

  • Twelve patients underwent the modified procedure since 2006.
  • Mean patient age was 63.2 years.
  • No in-hospital mortality or significant postoperative morbidity was observed; procedures were uneventful.

Conclusions:

  • The modified biological Bentall technique is simple and reproducible.
  • This modification simplifies reoperations for bioprosthetic degeneration.
  • The technique appears safe, without increasing operative risk or morbidity.