Objective: Bentall procedure is the standard treatment for combined diseases of the aortic valve and ascending aorta. Tissue-valved conduits have become increasingly popular. We report our results with tissue-valved conduits.
Methods: From 06/2000 – 12/2011, 274 patients (201 males, mean age 66 ± 11 years) received a tissue-valved conduit in our center. 182 (66%) patients received concomitant procedures including 73 CABG, 20 mitral valve operations and 149 aortic arch procedures, 40 of which were total aortic arch replacements. 9 patients received an elephant trunk. 30 patients (11%) had previous cardiac procedures. 37 (14%) patients had acute aortic dissection, type A (AADA). 120 patients received a pre-fabricated tissue-valved conduit and 155 patients a 'home-made 'conduit.
Results: 30 day mortality was 9% (n = 25), of these three were re-do and 9 were AADA patients, respectively. CPB and X-clamp time were 170 ± 72 and 108 ± 41 mins, respectively. Re-thoracotomy for bleeding occurred in 14% (n = 39). Other complications were acute renal failure requiring dialysis (n = 13; 5%), temporary or persistent neurological deficit (n = 25; 9%), prolonged ventilation (n = 47; 17%), respectively. The mean follow-up was 4.1 ± 3.0 years. Long term survival was 77%. There were no valve related re-operations.
Conclusions: This results of tissue-valved conduit show good early and long term results. Even in the age of valve-sparing operations, classical Bentall procedure is still the Gold standard, especially in older and complex cases. Results of valve-sparing operations still have to be compared with the excellent results of classical Bentall, especially in view of longer durability of modern tissue valves.
