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Published on: March 28, 2025
Long-term results of modified Bentall procedure using flanged composite aortic prosthesis
Kiyoshi Tamura1, Hirokuni Arai, Satoru Kawaguchi
1Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Purpose:
We have been using the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia in aortic root replacement procedures at our institution over the last twenty five years. Our objective was to evaluate the long-term results of aortic root replacement with this technique.
Methods:
A total of 73 patients from January 1984 to August 2010 were included in this study. The median age was 52.7 ± 14.4 years (range 28-80 years). There were 48 male and 25 female patients. 44 patients (60.3%) had annuloaortic ectasia, and 15 patients (20.5%) had acute type A aortic dissection. Marfan syndrome was recognized in 12 patients (16.5%).
Results:
The early mortality rate was 5.5% (n = 4). Causes of death were multiple organ failures in two patients and sepsis in another two patients. The actuarial survival rate was 84.2% at 5 years, 64.3% at 15 years and 51.9% at 25 years. Only one patient with aortitis needed a reoperation because of coronary pseudoaneurysm after 23 years from the previous operation.
Conclusion:
This modified Bentall procedure is reliable and safe, with superior long-term survival and a low rate of aortic reoperation.