Long-term survival and operative outcomes of the Bentall procedure for aortic root aneurysm, aortic dissection, and

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

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Christopher Lau1, Alexander Gregg1, Eilon Ram1

  • 1Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.

The Journal of Thoracic and Cardiovascular Surgery
|September 21, 2025
PubMed

Insights

The Bentall procedure offers low operative risk for aortic aneurysms and dissections. While endocarditis increases operative mortality, excellent long-term survival is achievable for all patients.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Aortic root pathology requires complex surgical intervention.
  • The Bentall procedure is a standard technique for aortic root replacement.
  • Outcomes vary based on the underlying diagnosis necessitating the procedure.

Purpose of the Study:

  • To evaluate the outcomes of the Bentall procedure for aortic aneurysms, dissections, and endocarditis.
  • To compare operative results and long-term survival across different primary diagnoses.
  • To identify factors influencing late mortality after aortic root replacement.

Main Methods:

  • Retrospective analysis of 1493 patients undergoing Bentall procedures from 1997 to 2023.
  • Stratification of patients based on primary diagnosis: aneurysm, dissection, or endocarditis.
  • Comparison of operative outcomes, including mortality and complications, and long-term survival.

Main Results:

  • Aneurysm repair was most common (92.3%), followed by dissection (5%) and endocarditis (2.7%).
  • Endocarditis patients experienced higher rates of acute renal failure and operative mortality.
  • Reexploration for bleeding was more frequent in the dissection group.
  • Ten-year survival was comparable across all groups (71.8%–83.7%).
  • Age, COPD, renal dysfunction, and ejection fraction predicted late mortality, not the primary diagnosis.

Conclusions:

  • The Bentall procedure is associated with low operative risk for aneurysms and selected dissections.
  • Endocarditis presents higher operative mortality but remains acceptable.
  • Patients surviving the initial surgery can expect excellent long-term survival regardless of the primary diagnosis.
Abstract

Keywords:
Bentallaortic dissectionaortic root replacementaortic valve endocarditis

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