ORIGINAL ARTICLES BENTALL OPERATION- A CLASICAL AORTIC ROOT RECONSTRUCTION WITH PROVED RESULT OVER YEARS

Background: The Bentall operation is considered the standard in the surgical treatment for aortic root aneurysm, with lowmortality and very good long results. Technical modifications have been added to the original description, regarding the coronary arteries reimplantation. Our purposewas to determine themortality,morbidity and long time events after composite graft replacement of the aortic root and to evaluate the risk factors associatedwith this procedure. Material andMethod: Between 1986 and 2002, at the University Cardiac Surgery Innsbruck, 67 patients underwent aortic root and/or the aortic arch replacement. From 67 patients, 57weremales and 30 patients (44.8%) underwent emergency procedures. Twenty eight patients (41.8%) presentedwith acute aortic dissection type A, 2 patients had chronic aortic dissection, 28 patients (41.8%) had an ascending aortic aneurysmcombinedwith aortic regurgitation, and 7 (10.5%) had an extension of the aneurysm into the aortic arch. All operations were performed using the coronary-button-method. Deep hypothermic circulatory arrest (DHCA) was necessary in 36 patients (53.7%). Results:Overall hospitalmortality was 9/67 patients (13.4%). The factors associatedwith earlymortality: aortic dissection, CPB time, aortic cross clamp time,DHCA, postop-erative lowcardiac output syndrome, postoperative renal failure requiringhemofiltration,multiorgan failure. Survival excludinghospital deathswas96%at 1 year, 90%at 3 years, 90 % at 5 years and 85 % at 7 years. Conclusion:Aortic root and ascending aorta replacement using amechanically valved composite graft is an operationwith low hospitalmortality especially in elective, non-dissecting cases. The long-term survival rates are good and themajority of patients are event-free after the operation