Stentless Composite Biological Aortic Valved Conduit for Bentall Operation
- #AC/AOR 01-O-10
- Adult Cardiac Surgery/Aortic. SESSION-1
- Oral
Stentless Composite Biological Aortic Valved Conduit for Bentall Operation
Guglielmo Stefanelli 1, Fabrizio Pirro 1, Luigi Steffanon 1, Vincenzo Smorto 1, Antonio Mingiano 1, Luca Weltert 2
1 hesperia hospital, modena, Italy; 2 european hospital, rome, Italy;
Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–B
Abstract
Aim of this study was to verify the feasibility and easiness of construction, implantation and the hemodynamic behaviour of a woven tubular prosthesis containing a 3F stentless valve for Bentall operation.
Methods:
Between April 2010 and August,2015,30 patients underwent Bentall operation,using a 3F® stentless valve included in a straight woven tube graft.Mean age was 66.3 yrs .Mean ischemic time was 108’,mean CPB time 123’.In the last 21 cases the bioroot was pre-assembled before clamping the aorta, with the size of implant obtained from precise intraoperative TEE Echographic measurements, and the mean cross clamping time dropped to 88'.The valve, one size smaller than the tube, was secured inside the graft by three 4-0 polypropylene sutures at 120°.Same stitches were used to fix the valve commissural tabs to the graft wall.Proximal anastomosis to the aortic root by U stitches, coronary arteries reimplantation and distal anastomosis by 5-0 polypropylene on teflon felt completed the procedure.
Results:
Early 30 days–in hospital mortality was 0%. One patient died one year after surgery for non-cardiac cause.The immediate post-operative transesophageal Echo showed in all cases a physiological movement of the valve leaflets whit images of linear and smooth flow and a mean pressure gradient of 8 mmHg. At last follow ( range: 2 months- 7 years ) all patients were in NYHA class I. Hemodynamic performance was unchanged with a peak pressure gradient of 13 mmHg and a mean pressure gradient of 9 mmHg.
Conclusions:
The 3F composite stentless bioroot represents a valid option for biological Bentall operation. We emphasize the importance of using a straight tube in order to keep the commissural tabs of 3F valve in a vertical alignment , avoiding any leaflet distortion.