We analyzed the postoperative short- and mid-term outcomes of a series of patients with
annuloaortic ectasia who underwent a modified Bentall operation in our clinic from September 2000 through March 2006. The study included 44 patients. Their average age was 53.4 +/- 14.1 years. The underlying disease was degenerative
aortic aneurysm in 42 patients (95.5%) and acute
aortic dissection in 2 patients (4.5%). Six patients (13.6%) had Marfan phenotype. Aortic insufficiency was moderate in 30 patients (68.2%) and severe in 14 patients (31.8%). In our modification of the Bentall technique, we completed the resection of the aortic root while leaving 5 to 10 mm of native aortic wall tissue to support the anastomosis. A long piece of
Teflon felt (width, 0.5-1 cm) was laid on the annulus, and nonpledgeted 2-0
polyester sutures were passed in turn through the
Teflon felt, the preserved aortic tissue, and the aortic annulus. A thin piece of
Teflon felt was also used in the coronary artery
reimplantation sites.
Fibrin glue was routinely applied to all anastomoses. There were no intraoperative deaths. One patient died in the hospital after surgery for acute type I
aortic dissection. Another patient died 1 year after the operation from prosthetic-valve
endocarditis. No patient required surgical correction of excessive postoperative
bleeding. Kaplan-Meier curves showed overall survival of 0.94 (95% confidence intervals, 0.9-0.99). We consider our approach an easy, effective way to minimize
bleeding from the anastomoses and at the aortic root--a common challenge in aortic surgery.