|
|
||||||||
Ann Thorac Surg 1992;53:38-46
© 1992 The Society of Thoracic Surgeons
Department of Cardiovascular Surgery, Texas Heart Institute and St. Luke's Episcopal Hospital, Houston, Texas, USA
* Address reprint requests to Dr Cooley, Texas Heart Institute, PO Box 20345, Houston, TX 77225-0345.
Bentall's technique for repair of annuloaortic ectasia has been associated with postoperative bleeding and with false aneurysms at the anastomotic site between the coronary orifices and valve-containing graft. To reduce the incidence of these complications, we modified the Bentall procedure, using a simplified technique to implant the graft and to create a fistula between the closed perigraft space and right atrium to control bleeding. A continuous suture of monofilament polypropylene was used to implant the prosthetic valve ring and to anastomose the coronary orifices to the Dacron fabric. In some instances, a brief period of hypothermic circulatory arrest was needed to perform the distal aortic anastomosis. Among 562 patients undergoing operation for aneurysm of the ascending aorta between January 1, 1980, and February 28,1990, 280 underwent graft replacement with a valve-containing composite conduit. Most (82%) had annuloaortic ectasia. In 267, we performed a classic Bentall procedure with direct anastomosis between the coronary orifices and fabric graft. The remaining 13 patients underwent other procedures for coronary connection. Early mortality was 5.0%. Reoperation for bleeding was needed in 13.2% of patients who underwent operation before we used the right atrial fistula technique and in 4.4% after we began to use the technique (p = 0.044). Actuarial survival was 71% at 5 years and 65% at 7 years. For hospital survivors, it was 76% at 5 years and 70% at 7 years. During follow-up, only 9 patients have required reoperation. A false aneurysm at the coronary anastomosis, which was associated with prosthetic valve endocarditis, developed in 1 patient. No permanent fistulas have developed. Thus, by using simplified methods to implant the graft and to control postoperative bleeding, the Bentall technique can be performed successfully with excellent early and late results.
This article has been cited by other articles:
![]() |
H. Koshiyama, M. Nakajima, S. Amenomori, and K. Tsuchiya A refined flanged Bentall technique using Valsalva tube graft for proximal reinforcement Eur J Cardiothorac Surg, December 1, 2011; 40(6): 1537 - 1539. [Abstract] [Full Text] [PDF] |
||||
![]() |
L.-W. Chen, X.-F. Dai, and X.-J. Wu A Modified Composite Valve Dacron Graft for Prevention of Postoperative Bleeding From the Proximal Anastomosis After Bentall Procedure Ann. Thorac. Surg., November 1, 2009; 88(5): 1705 - 1707. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. R. Brinster, R. J. Rizzo, and R. M. Bolman III Ascending Aortic Aneurysms , January 1, 2008; 3(2008): 1223 - 1250. [Full Text] |
||||
![]() |
M. S. Kalkat, M.-B. Edwards, K. M. Taylor, and R. S. Bonser Composite Aortic Valve Graft Replacement: Mortality Outcomes in a National Registry Circulation, September 11, 2007; 116(11_suppl): I-301 - I-306. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Lima, G. C. Hughes, A. Lemaire, J. Jaggers, D. D. Glower, and W. G. Wolfe Short-Term and Intermediate-Term Outcomes of Aortic Root Replacement with St. Jude Mechanical Conduits and Aortic Allografts Ann. Thorac. Surg., August 1, 2006; 82(2): 579 - 585. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. J. Zehr, T. A. Orszulak, C. J. Mullany, A. Matloobi, R. C. Daly, J. A. Dearani, T. M. Sundt III, F. J. Puga, G. K. Danielson, and H. V. Schaff Surgery for Aneurysms of the Aortic Root: A 30-Year Experience Circulation, September 14, 2004; 110(11): 1364 - 1371. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Kazui, K. Yamashita, H. Terada, N. Washiyama, T. Suzuki, K. Ohkura, and K. Suzuki Late reoperation for proximal aortic and arch complications after previous composite graft replacement in marfan patients Ann. Thorac. Surg., October 1, 2003; 76(4): 1203 - 1207. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Pacini, F. Ranocchi, E. Angeli, F. Settepani, M. Pagliaro, S. Martin-Suarez, R. Di Bartolomeo, and A. Pierangeli Aortic root replacement with composite valve graft Ann. Thorac. Surg., July 1, 2003; 76(1): 90 - 98. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. D. Milano, S. Pratali, G. Mecozzi, P. Boraschi, G. Braccini, E. Magagnini, and U. Bortolotti Fate of coronary ostial anastomoses after the modified Bentall procedure Ann. Thorac. Surg., June 1, 2003; 75(6): 1797 - 1801. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. G. Byrne, T. Gudbjartsson, A. N. Karavas, T. Mihaljevic, B. J. Phillips, S. F. Aranki, J. D. Rawn, and L. H. Cohn Biological vs. mechanical aortic root replacement Eur J Cardiothorac Surg, March 1, 2003; 23(3): 305 - 310. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. A. Anderson, R. J. Rizzo, and L. H. Cohn Ascending Aortic Aneurysms , January 1, 2003; 2(2003): 1123 - 1148. [Full Text] |
||||
![]() |
S. A. LeMaire, D. J. DiBardino, C. Koksoy, and J. S. Coselli Proximal aortic reoperations in patients with composite valve grafts Ann. Thorac. Surg., November 1, 2002; 74(5): S1777 - S1780. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Prifti, M. Bonacchi, G. Frati, P. Proietti, G. Giunti, G. Babatasi, M. Massetti, and G. Sani Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique Eur J Cardiothorac Surg, January 1, 2002; 21(1): 15 - 21. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Panos, B. Amahzoune, J. Robin, G. Champsaur, and J. Ninet Influence of technique of coronary artery implantation on long-term results in composite aortic root replacement Ann. Thorac. Surg., November 1, 2001; 72(5): 1497 - 1501. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Michielon, L. Salvador, U. Da Col, and C. Valfre Modified button-Bentall operation for aortic root replacement: the miniskirt technique Ann. Thorac. Surg., September 1, 2001; 72(3): S1059 - S1064. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. P. Ehrlich, M. A. Ergin, J. N. McCullough, S. L. Lansman, J. D. Galla, C. A. Bodian, and R. B. Griepp Favorable outcome after composite valve-graft replacement in patients older than 65 years Ann. Thorac. Surg., May 1, 2001; 71(5): 1454 - 1459. [Abstract] [Full Text] [PDF] |
||||
![]() |
K.-L. Chan A continuous murmur after surgery for dissecting ascending aortic aneurysm Ann. Thorac. Surg., June 1, 2000; 69(6): 1929 - 1931. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. B. Luciani, G. Casali, G. Faggian, and A. Mazzucco Predicting outcome after reoperative procedures on the aortic root and ascending aorta Eur J Cardiothorac Surg, May 1, 2000; 17(5): 602 - 607. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Westaby, T. Katsumata, and G. Vaccari Aortic root replacement with coronary button re-implantation: low risk and predictable outcome Eur J Cardiothorac Surg, March 1, 2000; 17(3): 259 - 265. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. B. Luciani, G. Casali, L. Barozzi, and A. Mazzucco Aortic root replacement with the Carboseal composite graft: 7-year experience with the first 100 implants Ann. Thorac. Surg., December 1, 1999; 68(6): 2258 - 2262. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Langley, S. J. Rooney, M. J. R. Dalrymple-Hay, J. M. F. Spencer, M. E. Lewis, D. Pagano, M. Asif, J. R. Goddard, V. T. Tsang, R. K. Lamb, et al. REPLACEMENT OF THE PROXIMAL AORTA AND AORTIC VALVE USING A COMPOSITE BILEAFLET PROSTHESIS AND GELATIN-IMPREGNATED POLYESTER GRAFT (CARBO-SEAL): EARLY RESULTS IN 143 PATIENTS J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1014 - 1020. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. M. Dossche, M. A.A.M. Schepens, W. J. Morshuis, A. B. de la Riviere, P. J. Knaepen, and F. E.E. Vermeulen A 23-year experience with composite valve graft replacement of the aortic root Ann. Thorac. Surg., April 1, 1999; 67(4): 1070 - 1077. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. G. Svensson, S. B. Labib, A. C. Eisenhauer, and J. R. Butterly Intimal Tear Without Hematoma : An Important Variant of Aortic Dissection That Can Elude Current Imaging Techniques Circulation, March 16, 1999; 99(10): 1331 - 1336. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. C. King, R. C. Kanithanon, K. S. Shockey, W. D. Spotnitz, C. G. Tribble, and I. L. Kron Replacing the atherosclerotic ascending aorta is a high-risk procedure Ann. Thorac. Surg., August 1, 1998; 66(2): 396 - 401. [Abstract] [Full Text] [PDF] |
||||
![]() |
U. Niederhauser, H. Rudiger, P. Vogt, A. Kunzli, G. Zund, and M. Turina Composite graft replacement of the aortic root in acute dissection Eur J Cardiothorac Surg, February 1, 1998; 13(2): 144 - 150. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. N. Girardi, N. G. Talwalkar, and J. S. Coselli Aortic Root Replacement: Results Using the St. Jude Medical/Hemashield Composite Graft Ann. Thorac. Surg., October 1, 1997; 64(4): 1032 - 1035. [Abstract] [Full Text] |
||||
![]() |
L. Lang-Lazdunski, Y. Pansard, and U. Hvass AORTIC VALVE REPLACEMENT IN RELAPSING POLYCHONDRITIS J. Thorac. Cardiovasc. Surg., July 1, 1997; 114(1): 131 - 132. [Full Text] |
||||
![]() |
A. D. Hilgenberg, C. W. Akins, D. L. Logan, G. J. Vlahakes, M. J. Buckley, J. C. Madsen, and D. F. Torchiana Composite Aortic Root Replacement With Direct Coronary Artery Implantation Ann. Thorac. Surg., October 1, 1996; 62(4): 1090 - 1095. [Abstract] [Full Text] |
||||
![]() |
L. H. Cohn, R. J. Rizzo, D. H. Adams, S. F. Aranki, G. S. Couper, N. Beckel, and J. J. Collins Jr Reduced Mortality and Morbidity for Ascending Aortic Aneurysm Resection Regardless of Cause Ann. Thorac. Surg., August 1, 1996; 62(2): 463 - 468. [Abstract] [Full Text] |
||||
![]() |
R. Magotra, M. Khaja, R. Shahani, S. Khanna, M. Mukadam, J. Khandeparkar, N. Agrawal, and A. Tendolkar Surgical Treatment of Aneurysms of the Ascending Aorta and Aortic Arch Asian Cardiovascular and Thoracic Annals, March 1, 1996; 4(1): 37 - 39. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Carrel Conservative surgical management of annulo-aortic dilatation Ann. Thorac. Surg., April 1, 1995; 59(4): 1038 - 1039. [PDF] |
||||
![]() |
M. G. Barnett, A. C. Fiore, K. J. Vaca, T. W. Milligan, and H. B. Barner Tailoring aortoplasty for repair of fusiform ascending aortic aneurysms Ann. Thorac. Surg., February 1, 1995; 59(2): 497 - 501. [Abstract] [PDF] |
||||
![]() |
A. Suzuki, J. Amano, M. Sunamori, T. Sakamoto, and H. Tanaka New composite graft repair for patients with and without Marfan's syndrome Ann. Thorac. Surg., November 1, 1994; 58(5): 1457 - 1461. [Abstract] [PDF] |
||||
![]() |
R. Soyer, J. P. Bessou, F. Bouchart, M. Redonnet, D. Mouton-Schleifer, and J. Arrignon Surgical treatment of infected composite graft after replacement of ascending aorta Ann. Thorac. Surg., August 1, 1994; 58(2): 425 - 428. [Abstract] [PDF] |
||||
![]() |
A. Ralph-Edwards, T. E. David, and J. Bos Infective endocarditis in patients who had replacement of the aortic root Ann. Thorac. Surg., August 1, 1994; 58(2): 429 - 432. [Abstract] [PDF] |
||||
![]() |
V. L. Gott Invited commentary Ann. Thorac. Surg., June 1, 1994; 57(6): 1674 - 1674. [PDF] |
||||
![]() |
S. B. Park and T. D. Maher Jr Modification of the aortic composite graft using the button-in technique Ann. Thorac. Surg., April 1, 1994; 57(4): 1035 - 1036. [Abstract] [PDF] |
||||
![]() |
C. Bassano, G. Rabitti, and L. C. D'Alessandro Replacement of a prosthetic valve after the bentall procedure Ann. Thorac. Surg., January 1, 1994; 57(1): 230 - 232. [Abstract] [PDF] |
||||
![]() |
R. J. Landreneau, S. R. Hazelrigg, M. J. Mack, R. D. Dowling, D. Burke, J. Gavlick, M. K. Perrino, P. S. Ritter, C. M. Bowers, J. DeFino, et al. Postoperative pain-related morbidity: Video-assisted thoracic surgery versus thoracotomy Ann. Thorac. Surg., December 1, 1993; 56(6): 0003497593906677 - 3497593906677. [Abstract] [PDF] |
||||
![]() |
T. Carrel, M. Pasic, R. Jenni, T. Tkebuchava, and M. I. Turina Reoperations after operation on the thoracic aorta: Etiology, surgical techniques, and prevention Ann. Thorac. Surg., August 1, 1993; 56(2): 259 - 269. [Abstract] [PDF] |
||||
![]() |
G. B. Luciani, A. Fabbri, G. Faggian, P. Marino, and A. Mazzucco Mechanical assist device for right ventricular failure after acute aortic dissection Ann. Thorac. Surg., August 1, 1993; 56(2): 363 - 366. [Abstract] [PDF] |
||||
![]() |
K. Kawazoe, K. Eishi, and Y. Kawashima New modified bentall procedure: Carrel patch and inclusion technique Ann. Thorac. Surg., June 1, 1993; 55(6): 1578 - 1579. [Abstract] [PDF] |
||||
![]() |
L. G. Svensson, E. S. Crawford, K. R. Hess, J. S. Coselli, and H. J. Safi Composite valve graft replacement of the proximal aorta: Comparison of techniques in 348 patients Ann. Thorac. Surg., September 1, 1992; 54(3): 427 - 439. [Abstract] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |