• Hyun-Chel Joo, Byung-Chul Chang, Young-Nam Youn, Kyung-Jong Yoo, and Sak Lee.
• Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul 120-752, Korea.
• Yonsei Med. J. 2012 Sep 1; 53 (5): 915-23.

PurposeWe retrospectively analyzed 28 years of experience with the Bentall procedure in patients with aortic valve, aortic root, and ascending aortic disease.Materials And MethodsBetween March 1982 and December 2010, a total of 218 patients underwent the Bentall procedure using a composite valved conduit. The "inclusion technique" was used in 30 patients (13.8%), the "open-button technique" in 181 patients (83.0%), and the Cabrol technique in 7 patients (3.2%).ResultsThe early mortality rate was 5.5% (12/218). The mean follow-up duration was 108.0±81.0 months (range: 1-329 months). Seven patients required re-operation, and 1 patient required stent graft insertion at the descending thoracic aorta for progression of aortic arch or descending thoracic aortic dissection or aneurysm after the first operation, and 5 of them had Marfan syndrome. Kaplan-Meier estimated survival rates at 1, 5, 10, 20, and 25 years were 90.4%, 82.7%, 77.6%, 65.3%, and 60.3%, respectively. Freedom from reoperation rates at 1, 5, 10, 20, and 25 years were 99.0%, 98.3%, 95.5%, 90.8%, and 90.8%, respectively.ConclusionIn our experience, the Bentall procedure provided optimal survival with improved functional status. The disease of the aorta may progress, especially in patients with Marfan syndrome. Therefore, careful follow-up with regular computed tomography angiograms should be performed in these patients.

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