Comparison of postoperative results of patients undergoing Bentall surgery using Biovalsalva and composite grafts

Biovalsalva and composite grafts in Bentall surgery

Authors

DOI:

https://doi.org/10.5281/zenodo.8322524

Keywords:

Bentall operation, biovalsalva graft, composite graft, mortality

Abstract

Objective: Biovalsalva grafts have been used as new grafts in recent years due to the need to reduce complications and mortality of Bentall surgery. This study compared the postoperative results of patients who underwent Bentall operations using Biovalsalva grafts and those who used valved conduit grafts.
Methods: Between January 2015 and March 2017, the study included 40 patients who were diagnosed with ascending aortic aneurysms (AAAs) and underwent the Bentall procedure in our clinic. Twenty patients using Dacron grafts were included in Group I and 20 patients using Biovalsalva grafts were included in Group II. The patients were compared in terms of cardiopulmonary bypass (CPB), cross-clamp times, preoperative and postoperative first month echocardiography (ECHO) results, length of stay in the hospital and intensive care unit, amount of drainage and inotropic use.
Results: The age of the patients using Biovalsalva grafts was significantly higher than those using composite grafts (p<0.001). The comparison of the patients in terms of CPB time showed no significant difference (p=0.174). The cross-clamp time was significantly lower in patients treated with Biovalsalva grafts than in those treated with composite grafts (p=0.023). The mortality results between the two groups showed no significant difference.
Conclusion: Although the Biovalsalva graft did not make any additional difference in terms of postoperative ECHO findings, morbidity, or mortality, it significantly shortened the cross-clamp time. Better results can be achieved with the increase in the use of Biovalsalva grafts.

References

Mookhoek A, Korteland NM, Arabkhani B, Di Centa I, Lansac E, Bekkers JA, et al. Bentall Procedure: A systematic review and Meta Analysis. Ann Thorac Surg. 2016;101:1684-9.

Van HD, Pham TB, Chau CL, Vuong NL. Modified Bentall procedure: A 15-year single-center clinical experience. Asian Cardiovasc Thorac Ann. 2022;30:779-87

Kawazoe K, Eishi K, Kawashima Y. New modified Bentall procedure: Carrel patch and inclusion technique. Ann Thorac Surg. 1993;55:1578-9.

Mazine A, David TE, Lafreniere-Roula M, Feindel CM, Ouzounian M. Early outcomes of the Bentall procedure after previous cardiac surgery. J Thorac Cardiovasc Surg. 2021;162:1063-71.

Gouveia E, Melo R, Stana J, Prendes CF, Kölbel T, Peterss S, et al. Current state and future directions of endovascular ascending and arch repairs: The motion towards an endovascular Bentall procedure. Semin Vasc Surg. 2022;35:350-63

Uzun K, Tekümit H, Tataroğlu C, Kara H. Kompozit greftler ile aort kök replasmanlarında yeni bir proksimal

anastomoz tekniği: Etekli çift kat anastomoz. Türk Göğüs Kalp Damar Cerr Derg. 2015; 23(3): 467-72.

Apaydin AZ, İslamoglu F, Askar FZ, Engin C, Posacığlu H, Yağdi T, et al. Immediate clinical aoutcome after prolonged periods of brain protection: retrospective comparison of hypotermic circulatory arrest, retrograde and antegrade perfusion. J Card Surg. 2009;24:486-9.

Kaya A, Heijmen RH, Kelder JC, Morshuis WJ. First 102 patients with the Biovalsalva conduit for aortic root replacement. Ann Thorac Surg. 2012;94:72-7.

Leiria TL, Lopes RD, Williams JB, Katz JN, Kalil RA, Alexander JH. Anthitrombotic therapies in patients with prosthetic heart valves : guidelines translated for the clinician. J Thromb Thrombolysis. 2011;31:514-22.

Tan ME, ter Woorst FJ, Elenbaas TW, van Straten AH. Dissected biovalsalva prosthesis. Eur J Cardiothorac Surg. 2009;36:400.

Yikuno AY, Kelvin KW Lau, Baig K, Uppal Rakesh. Chronic dissection and aneurysmal dilatation of a biovalsalva conduit. Ann Thorac Surg. 2013; 96:298-300.

Chocron S, Kaili D. Re: Dissected biovalsalva prosthesis. Eur J Cardiothorac Surg. 2010;37:980 ; author reply 980-1.

Galicia-Tornell MM, Marin - Solis B, Fuentes - Orozco C, Martinez- Martinez M, Villalpando-Mendoza E, Ramirez-Orozco F. Bentall procedure in ascending aortic aneurysm: hospital mortality. Cir Ciruj. 2010;78:43-9.

Chirichilli I, Irace FG, D’Aleo S, Folino G, Weltert LP, Scaffa R, et al. Long-term follow-up of Bentall procedure using the Perimount bioprosthesis and the Valsalva graft. Interact Cardiovasc Thorac Surg. 2020;30:679-84.

Lechiancole A, Vendramin I, Sponga S, Piani D, Benedetti G, Meneguzzi M, et al. Bentall procedure with the CarboSeal™ and CarboSeal Valsalva™ composite conduits: long-term outcomes. Interact Cardiovasc Thorac Surg. 2021;33:93-100.

Igarashi T, Satokawa H, Sato Y, Takase S, Wakamatsu H, Seto Y, et al. Long-term results of modified Bentall procedures: 18-year experience of the flanged tecnique. Fukushima J. Med. Sci. 2021;67:119-27.

De Paulis R, Torre M, Scaffa R. Straight tube versus Valsalva graft for valve-sparing operation. Annals of Cardiothoracic Surgery. 2023;12:358-60

De Paulis R, Scaffa R, Weltert L, Salika A. Mimicking mother nature: The Valsalva graft. The Journal of Thoracic and Cardiovascular Surgery. 2020;159:1758-63

Scaffa R, Weltert L, Salica A, De Paulis R. The Skirt and Collar of The Valsalva Graft: One Dress Fits All. Surg Technol Int. 2021;38:271-7

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Published

2023-09-08

How to Cite

Çiçek, A., Güner, Y., Yalçın, M., & Erkanlı, K. (2023). Comparison of postoperative results of patients undergoing Bentall surgery using Biovalsalva and composite grafts: Biovalsalva and composite grafts in Bentall surgery. The Injector, 2(3), 128–136. https://doi.org/10.5281/zenodo.8322524

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Original Article