More than 20-year experience of Bentall operation with mechanical prostheses for chronic aortic root aneurysm

Objectives: Long-term results of Bentall operations with mechanical prostheses were analyzed and evaluated over 30 years.

Methods: Seventy-one patients aged 50.2 ± 1.8 years old underwent an elective Bentall operation from 1975 to 2013 for chronic aortic root aneurysm, while 129 patients aged 51.6 ± 1.3 underwent isolated AVR with a mechanical valve for pure aortic regurgitation. The follow-up was completed for a total of 2,336-patient-years in 99.5 % of these patients.

Results: No significant differences were observed in the hospital mortality (2.8 and 0.78 %), actuarial survival rate (43.3 ± 9.9 and 50.0 ± 9.2 %), freedom from valve-related death (84.9 ± 6.8 and 68.1 ± 11 %), and freedom from valve-related morbidity (43.7 ± 19 and 40.1 ± 15 %) at 30 years between the two groups. No significant differences were observed in the valve-related events; however, a higher incidence of rupture of aortic aneurysm was observed in the Bentall group (P = 0.0005).

Conclusions: Both our short- and long-term results of Bentall operation with mechanical prostheses were satisfactory at 30 years after the surgery and were comparable with those of simple AVR. However, to prevent rupture of the aortic aneurysm, special care should be taken after the primary Bentall operations.