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How To Do It

Modified Bentall Operation With Bioprosthetic Valved Conduit: Columbia University Experience

Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York

Accepted for publication September 19, 2008.

^_* Address correspondence to Dr Stewart, Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Ave, New York, NY 10019 (Email: as2276{at}columbia.edu).

A conduit was made by sewing a bovine pericardial valve into a graft conduit with the pseudo-sinuses of Valsalva. The graft collar below the valve cuff ring was sewn to the aortic annulus with interrupted pledgeted sutures. From August 2005 to February 2008, 68 patients underwent aortic root replacements with this technique. Operative mortality was 2.9% (2 acute aortic dissection patients died). During median follow-up of 11 months, 1 patient had reoperation for conduit failure due to infectious endocarditis. This technique is safe and feasible with favorable early outcomes. Because the valve is sewn above the outflow tract, superior hemodynamics are achieved. Reoperation may be accomplished by removal of the valve rather than full root re-replacement.