[Successful treatment of aortic prosthetic valve endocarditis and aortic root abscess by Bentall procedure]

A 53-year-old woman had undergone aortic valve replacement in 1990. Three years later, aortic prosthetic valve endocarditis and aortic root abscess had been noted. Debridement of all apparently infected tissue created left ventricular-aortic discontinuity, but the orifice of the coronary arteries were intact. We decided to reconstruct the left ventricular outflow tract and aortic root by Bentall procedure. Composite graft was made with 26 mm gelseal tube graft and a 23 mm SJM prosthetic valve, and the coronary ostia were sutured into the side of the graft. The patient's recovery was uneventful, and the aortography revealed no aortic regurgitation. We suggest that Bentall procedure using gelseal tube graft is useful to reconstruct the left ventrivular-aortic discontinuity if the coronary ostia were intact.