A Simple Modification in the Bentall Operation for Better Results (Added Protection Layer)

Document Type : Original Article


1 Cardiovascular Surgery, Faculty of Medicine, Hamedan University of Medical Sciences, IR Iran.

2 Department of Cardiac Surgery, Faculty of Medical Sciences, Imam Khomeini Medical and Research Centre, Tehran University of Medical Sciences, Tehran, IR Iran.

3 Department of Anesthesiology, and Faculty of Medical Sciences, Imam Khomeini Medical and Research Centre, Tehran University of Medical Sciences, Tehran, IR Iran.


Background: Bleeding and pseudoaneurysm formation are the dangerous complications of the Bentall operation. We made a simple modification to the proximal anastomosis in the Bentall operation to reduce postoperative bleeding and false aneurysm incidence. This article presents a review of the early results.
Methods: Totally, 171 consecutive patients (126 men and 45 women) underwent aortic root replacement between September 2014 and April 2020: as an elective operation in 130 patients (76.02%) and as an emergent or urgent operation in 41 (23.98%). No exclusion criteria were applied. All the Bentall operations during the study period were performed via the same surgical technique. Statistical analysis was conducted with the SPSS 11.0 statistical software package (SPSS, Chicago, IL, USA). Continuous variables were expressed as the mean ± the standard deviation and compared using the unpaired 2-tailed t test, and categorical variables were analyzed using the χ2 test or the Fisher exact test, where appropriate.
Results: The mean duration of cardiopulmonary bypass was 88.30 minutes, and the mean duration of aortic clamping was 53.17 minutes. Reoperation was required due to postoperative bleeding in 14 cases (8.19%). The early mortality rate was 8.77%, and the incidence of complications was 15.19%.
Conclusions: Our simple modification, which was the addition of a protection layer, to the standard technique of the Bentall operation did not significantly increase the duration of cardiopulmonary bypass, and it seemed to have caused a significant decrease in bleeding after surgery and the need for reoperation. (Iranian Heart Journal 2022; 23(3): 42-48)


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