Purpose: We have been using the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia in aortic root replacement procedures at our institution over the last twenty five years. Our objective was to evaluate the long-term results of aortic root replacement with this technique.
Methods: A total of 73 patients from January 1984 to August 2010 were included in this study. The median age was 52.7 ± 14.4 years (range 28-80 years). There were 48 male and 25 female patients. 44 patients (60.3%) had annuloaortic ectasia, and 15 patients (20.5%) had acute type A aortic dissection. Marfan syndrome was recognized in 12 patients (16.5%).
Results: The early mortality rate was 5.5% (n = 4). Causes of death were multiple organ failures in two patients and sepsis in another two patients. The actuarial survival rate was 84.2% at 5 years, 64.3% at 15 years and 51.9% at 25 years. Only one patient with aortitis needed a reoperation because of coronary pseudoaneurysm after 23 years from the previous operation.
Conclusion: This modified Bentall procedure is reliable and safe, with superior long-term survival and a low rate of aortic reoperation.
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http://dx.doi.org/10.5761/atcs.oa.12.01943 | DOI Listing |
J Thorac Cardiovasc Surg
January 2025
University of Maryland School of Medicine, Division of Cardiothoracic Surgery. Electronic address:
Objective: Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD.
Methods: From January 2018 to January 2023, 29 patients who were considered high risk for open operation underwent endovascular aortic repair.
SAGE Open Med Case Rep
December 2024
Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Nagano, Japan.
We present a case of an 82-year-old woman who developed sustained heart failure with left ventricular dyssynchrony after the modified Bentall procedure. Persistent circulatory instability and complete atrioventricular block suggested coronary artery stenosis. Multidetector computed tomography revealed stenosis of the grafted portion of the coronary artery.
View Article and Find Full Text PDFJ Cardiothorac Surg
December 2024
Department of Cardiothoracic Surgery, University Hospitals NHS North Midlands NHS Trust, Stoke-on-Trent, UK.
Six months following modified Bentall procedure a patient presented with angina and acute ST depression. CT coronary angiogram revealed severe narrowing of the left main coronary artery. Minimal invasive off pump coronary artery bypass grafting avoided complex reoperative surgery and delivered an excellent clinical outcome.
View Article and Find Full Text PDFJ Card Fail
December 2024
Department of Cardiovascular Diseases and Health Sciences Research and the William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota. Electronic address:
Introduction: Sirolimus (SRL) mitigates cardiac allograft vasculopathy (CAV) progression and confers renal protection after heart transplantation (HT). However, its safety and efficacy in patients undergoing combined heart and kidney transplantation (HKT) are unclear. This study aimed to investigate the impact of conversion from calcineurin inhibitors (CNIs) to SRL on CAV progression, renal function, and outcomes in HKT compared with isolated HT.
View Article and Find Full Text PDFAnn Thorac Surg
December 2024
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland Clinic, Cleveland, Ohio.
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