RF56 OPERATIVE AND SHORT-TERM RESULTS OF THE BENTALL OPERATION

Background and Aim: To analyse short-term results after the Bentall operation and get clinical considerations. Methods: One hundred and twenty-two patients (mean age 60.4 ± 15.8 years, 99 males,23 females) underwent Bentall operation from January 2015 to December 2017 for treatment of ascending aorta expansive aneurysm (i.e. degenerative aneurysm with tricuspid aortic valve, n = 69; bicuspid valve, n = 37; Marfan syndrome and other genetical disorders, n = 13; redo procedures n = 3). Associate procedures (i.e. coronary artery bypass grafting, mitral valve replacement, other) were performed in 26 patients (21.3%). Euroscore II was 4.7% ± 3.9%. Mean follow-up (99.2% complete) was 20 ± 10 months. Results: In-hospital mortality was 1.6% (1% for isolated Bentall). Three-year survival, freedom from cardiac death, from endocarditis, frome reoperation were 97 ± 1.2%, 99 ± 1.3%, 93 ± 5.1%, 98 ± 1.8%, respectively. No thromboembolism and major bleeding complications were observed. Independent predictors of all-cause death were preoperative higher left ventricular (LV) end-diastolic diameter (71.6 ± 12 vs 53.6 ± 8.6 mm; P = 0.009), LV end-systolic diameter (47.7 ± 9.2 vs 36.8 ± 7.9 mm; P = 0.02), lower LV ejection fraction (43.3 ± 15 vs 56.2 ± 8.7%; P = 0.015). Survival was 98.4 ± 1.6% after isolated Bentall, and 92 ± 5.4% after associated procdures (P = 0.04). As compared to preoperative values, clnical and echocardiography follow-up showed improvement of LV function and NYHA class. Conclusions: Excellent results can be expected after Bentall operation. Low rate of operative mortality and late complications, and significant improvement of clinical status make this operation the gold standard and the reference surgery therapy for the treatment of ascending aorta aneurysms. In presence of dilatation and dysfunction of the left ventricle, adequate medical treatment is necessary to improve survival.