Contemporary Midterm Echocardiographic Outcomes of Bentall Procedure and Aortic Valve Sparing Root Replacement

Background: Ascending aortic involvement in Behçet’s disease is very rare, and often accompanied by aortic root dilatation. In cases with aortic valve insufficiency without valve structure impairment, valve-sparing surgery can be performed. This study aimed to investigate the mid-term results of patients with ascending aortic involvement and selected surgical procedures according to the valve structure among those vascular Behçets disease.Methods: A total of 13 Behçet’s disease with aortic involvement operated at our center from January 2012 to 2018 was retrospectively investigated. Bentall or david valve-sparing operations were preferred according to the aortic valve status. Postoperative echocardiography and computed tomography imaging was performed periodically for aortic valve competence and pseudoaneurysm formation.Results: Bentall procedure was performed in 7 (54%) patients, and 6 (46%) patients were undergone valve-sparing David procedure. Operative mortality was 7.7%, one patient died of major gastrointestinal bleeding 3 months after the operation. After 51±23 (ranged 23 to 94) months of follow-up, no other mortality occurred, overall survival rates were 84.6%, two patients had minimally aortic regurgitation and one patient had mild regurgitation in David procedure. In Bentall procedure, no paravalvular leakage was found during follow-up.Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.

Download Full-text

Mid-term Outcomes of Valve-sparing Aortic Root Replacement Versus the Bentall Procedure for Middle-aged Chinese Patients with Acute DeBakey I Aortic Dissection: A Single-center Retrospective Study.

10.21203/rs.3.rs-123267/v1 ◽

2020 ◽

Author(s):

Qingsong Wu ◽

Zhisheng wang ◽

Zhihuang Qiu ◽

Yue Shen ◽

Xiaodong Chen ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Root Replacement ◽

Chinese Patients ◽

Middle Aged ◽

Bleeding Events ◽

Aged Patients ◽

Bentall Procedure ◽

Group A ◽

Valve Sparing

Abstract Background: The mid-term and long-term efficacies of valve preservation in acute DeBakey I aortic dissection(AD) are controversial. Thus, it is unclear whether middle-aged patients with acute DeBakey I AD should undergo valve-sparing procedures or the Bentall procedure in an emergency setting.Methods: This study included 213 middle-aged Chinese patients(30-60 years old) who were treated for acute DeBakey I AD between January 2009 and June 2015. The treatments involved valve-sparing aortic root replacement(VSARR)(117 patients) or the Bentall procedure(96 patients). Preoperative, intraoperative, postoperative, and follow-up data were analyzed. Echocardiography and thoracoabdominal computed tomography angiography(CTA) findings were reviewed at 3 months, 1 year, and then annually after surgery. Results: No significant differences were observed in terms of the preoperative, intraoperative, in-hospital mortality, and postoperative parameters. There were also no significant differences in aortic regurgitation(AR). However, follow-up examinations using CTA revealed that 6 patients had endoleakage at the distal end of the triple-branched stent(0/110 patients [0.0%] vs. 6/90 patients [6.7%], P=0.022). The anticoagulation-related thromboembolism/bleeding events was significantly lower in group A than in group B(0/110 patients [0.0%] vs. 11/90 patients [11.1%], P=0.001). And postoperative aortic valve re-operation rate was significantly lower in group A (1/110 patients [0.9%] vs. 8/90 patients [8.9%], P=0.020). There was no significant difference in survival during the follow-up period (log-rank P>0.05).Conclusion: For middle-aged patients with acute DeBakey I AD, VSARR were associated with a lower rate of endoleakage at the distal end of the triple-branched stent, thromboembolism/bleeding events and aortic valve re-operation(vs. the Bentall procedure) .

Download Full-text

Long-Term Single-Center Experience in Aortic Root Surgery: Aortic Valve-Sparing Surgery versus Bentall Procedure

10.1055/s-0040-1705408 ◽

2020 ◽

Author(s):

J. Petersen ◽

D. Gaekel ◽

E. Girdauskas ◽

H. Reichenspurner ◽

C. Detter

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Single Center ◽

Single Center Experience ◽

Bentall Procedure ◽

Aortic Root Surgery ◽

Valve Sparing

Download Full-text

Comparing outcomes between valve-sparing root replacement and the Bentall procedure in proximal aortic aneurysms: systematic review and meta-analysis

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz211 ◽

2019 ◽

Vol 29 (6) ◽

pp. 911-922 ◽

Cited By ~ 3

Author(s):

Mohammad Yousuf Salmasi ◽

Iakovos Theodoulou ◽

Priyanka Iyer ◽

Mohaimen Al-Zubaidy ◽

Danial Naqvi ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Meta Analysis ◽

Aortic Aneurysms ◽

Bentall Procedure ◽

Significant Difference ◽

Valve Function ◽

Short And Long Term ◽

Valve Sparing

AbstractIn aortic root aneurysms, the challenge of a valve-sparing aortic root replacement (VSRR) procedure is to ensure durable aortic valve function without reintervention. Although the Bentall procedure defers the durability of valve function to the prosthesis, short- and long-term complications tend to be higher. The aim of this study was to compare the outcomes of VSRR and Bentall procedures in patients with aortic root aneurysms. A systematic literature review was conducted using PubMed regarding the outcomes of the Bentall procedure compared with those of VSRR from the inception of the 2 procedures until July 2018. Studies with short- and long-term comparative data were included. An initial search yielded 9517 titles. Thirty-four studies were finally included for meta-analysis (all retrospective, non-randomized), comprising 7313 patients (2944 valve-sparing and 4369 Bentall procedures) with no evidence of publication bias. Operative mortality was found to be significantly lower in the VSRR group [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.37–0.70; P < 0.001] despite overall higher cardiopulmonary bypass and aortic cross-clamp times. The 5-year survival rate was also more favourable in the VSRR group (OR 1.93 95% CI 1.15–3.23; P < 0.05). Significantly lower rates of cerebral thromboembolism (OR 0.668, 95% CI 0.477–0.935; P = 0.019) and heart block (OR 0.386, 95% CI 0.195–0.767; P = 0.007) were also found after VSRR. There was no significant difference in rates of reoperation between the groups at long-term follow-up (OR 1.32, 95% CI 0.75–2.33; P = 0.336). Meta-regression of patient and operative covariates yielded no influence on the main outcomes (P > 0.05). These findings suggest that VSRR is an appropriate and potentially better treatment option for a root aneurysm when the aortic valve is repairable.

Download Full-text

Mid-term outcomes of modified valve-sparing aortic root replacement versus the Bentall procedure for middle-aged Chinese patients with acute DeBakey I aortic dissection: a single-center retrospective study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02014-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qingsong Wu ◽

Zhisheng Wang ◽

Zhihuang Qiu ◽

Yue Shen ◽

Xiaodong Chen ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Root Replacement ◽

Chinese Patients ◽

Middle Aged ◽

Bleeding Events ◽

Aged Patients ◽

Bentall Procedure ◽

Group A ◽

Valve Sparing

Abstract Background The mid-term and long-term efficacies of valve preservation in acute DeBakey I aortic dissection (AD) are controversial. Thus, it is unclear whether middle-aged patients with acute DeBakey I AD should undergo modified valve-sparing procedures or the Bentall procedure in an emergency setting. Methods This study included 213 middle-aged Chinese patients (under 60 years old) who were treated for acute DeBakey I AD between January 2009 and June 2015. The treatments involved modified valve-sparing aortic root replacement (VSARR) (117 patients) or the Bentall procedure (96 patients). Preoperative, intraoperative, postoperative, and follow-up data were analyzed. Echocardiography and thoracoabdominal computed tomography angiography (CTA) findings were reviewed at 3 months, 1 year, and then annually after surgery. Results No significant differences were observed in terms of the preoperative, intraoperative, in-hospital mortality, and postoperative parameters. There were also no significant differences in aortic regurgitation (AR). However, follow-up examinations using CTA revealed that 6 patients had endoleakage at the distal end of the triple-branched stent (0/110 patients [0.0%] vs. 6/90 patients [6.7%], P = 0.022). The anticoagulation-related thromboembolism/bleeding events was significantly lower in group A than in group B (0/110 patients [0.0%] vs. 11/90 patients [11.1%], P = 0.001). And postoperative aortic valve re-operation rate was significantly lower in group A (1/110 patients [0.9%] vs. 8/90 patients [8.9%], P = 0.020). There was no significant difference in survival during the follow-up period (log-rank P > 0.05). Conclusion For middle-aged patients with acute DeBakey I AD, VSARR were associated with a lower rate of endoleakage at the distal end of the triple-branched stent, thromboembolism/bleeding events and aortic valve re-operation (vs. the Bentall procedure).

Download Full-text