Abstract/References
Long-term results of modified bentall procedures: 18-year experience of the flanged technique
Takashi Igarashi, Hirono Satokawa, Yoichi Sato, Shinya Takase, Hiroki Wakamatsu, Yuki Seto, Hiroyuki Kurosawa, Masumi Iwai-Takano, Tsuyoshi Fujimiya, Hiroharu Shinjo, Keiichi Ishida, Hitoshi Yokoyama
Author information
- Takashi Igarashi
Department of Cardiovascular Surgery, Fukushima Medical University - Hirono Satokawa
Department of Cardiovascular Surgery, Fukushima Medical University - Yoichi Sato
Department of Cardiovascular Surgery, Yonezawa City Hospital - Shinya Takase
Department of Cardiovascular Surgery, Fukushima Medical University - Hiroki Wakamatsu
Department of Cardiovascular Surgery, Fukushima Medical University - Yuki Seto
Department of Cardiovascular Surgery, Fukushima Medical University - Hiroyuki Kurosawa
Department of Cardiovascular Surgery, Fukushima Medical University - Masumi Iwai-Takano
Department of Cardiovascular Surgery, Fukushima Medical University - Tsuyoshi Fujimiya
Department of Cardiovascular Surgery, Fukushima Medical University - Hiroharu Shinjo
Department of Cardiovascular Surgery, Fukushima Medical University - Keiichi Ishida
Department of Cardiovascular Surgery, Fukushima Medical University - Hitoshi Yokoyama
Department of Cardiovascular Surgery, Fukushima Medical University
Abstract
Objectives: To evaluate the early and late outcomes of the modified Bentall procedure with the flanged technique.
Methods: We reviewed the medical records of 63 patients who had undergone root replacement by the modified Bentall procedure at our institute between January 2001 and December 2018. In most cases, we adopted a composite graft constructed with a mechanical valve or bioprosthesis and a Dacron graft by the flanged technique. Since 2011, we have used Valsalva grafts.
Results: Mean age 57 ± 16 years, range 16-80, male 43 cases. The mean follow-up was 75 ± 56 months (range 0-216). Through April 1, 2020, we could follow up on 61 cases (97%) within a six-month period. Hospital mortality was 7.9% (4.8% in elective cases). In late follow-up, eight deaths were observed. In the bio-Bentall group (n=26), no deaths or major adverse valve-related events (MARVEs) occurred. In the mechanical Bentall group (n=37), seven cases of MARVEs, including two cerebral hemorrhages and one cerebral embolism, were observed. All patients were free from MARVEs at 5 years post procedure in the bio-Bentall group, and 93.8% and 76.8% were event-free at 5 years and 10 years, respectively, in the mechanical Bentall group.
Conclusions: The 18-year results of the modified Bentall procedure were acceptable, providing excellent outcomes in the bio-Bentall group. The flanged technique enabled the use of a larger prosthesis, which may have resulted in good durability with the bio-Bentall procedure.
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