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Modified Bentall operation - outcomes with emphasis on the aortic index
Daniel Gouveia1, Jorge Casanova, Armando Abreu
1Serviço de Cirurgia Torácica do Hospital de S. João, Porto, Portugal.
Summary
The modified Bentall operation shows low mortality and excellent long-term outcomes for aortic valve disease. The aortic index aids surgeons in deciding when to replace the ascending aorta during elective procedures.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- The modified Bentall operation is a complex procedure for aortic valve disease.
- Deciding on ascending aorta replacement in elective cases can be challenging.
- The aortic index is a potential tool to guide surgical decisions.
Purpose of the Study:
- To analyze early and long-term outcomes of the modified Bentall operation with a mechanical prosthesis.
- To evaluate the utility of the aortic index in elective ascending aorta replacement decisions.
- To assess the safety and efficacy of the procedure in a single institution.
Main Methods:
- Prospective study of 126 patients over 16 years.
- Included elective (82) and urgent (44) operations for aortic dissection or endocarditis.
- Kaplan-Meier survival analysis and Cox regression were used for time-related outcomes.
Main Results:
- Overall early mortality was 7.9%, with no deaths in elective primary operations.
- The aortic index was calculated in 93% of elective procedures (range 1.9-6.9 cm²/m²).
- 15-year survival was 67.3%, with 95.6% freedom from reoperation for local complications.
Conclusions:
- The modified Bentall operation offers low mortality and morbidity in selected patients.
- Long-term local complication rates are exceptionally low.
- The aortic index is a valuable aid for surgeons managing dilated ascending aortas.
