Bentall De Bono surgery using a composite graft containing a biological prosthesis of the aortic valve under artificial circulation: A clinical case study

Objective: The aim of our article is to report the positive outcome of the prosthetic biological aortic valve replacement of using Bentall De Bono procedure under artificial circulation. Case presentation: A male patient, born in 1954, was admitted to our clinic with complaints of marked dyspnea and weakness at the slightest physical load, accompanied by heart palpitations. The patient had a history of congenital heart defect, namely bicuspid aortic valve. His condition had been deteriorating since August 2023, with symptoms of heart failure, pleural effusion and hepatomegaly. Evacuation of pleural effusion was repeatedly performed. On further examination, echocardiography revealed marked atheromatous of the ascending aorta. Aneurysm of the ascending aorta, dilatation of the aortic root, annuloaortic ectasia of the bicuspid aortic valve. Aortic regurgitation of the 2nd degree. Mitral regurgitation of the 2nd degree. On chest computed tomography, the heart was normally located, minimal accumulation of effusion up to 4.0 mm was noted in the pericardial cavity. The aorta was located typically, the diameter of the ascending section was up to 63 mm, aortic arch up to 42 mm, descending aorta up to 27 mm, the contours were clear, no wall thickening was noted. Bentall De Bono method surgery was performed using a biological valve under artificial circulation and hemodynamic support. The patient was discharged on the 10th day after the operation, only insignificant mitral insufficiency was noted on control echocardiography. Conclusion: Bentall De Bono operation using a biological prosthesis is the most justified treatment tactic if there is no history of rheumatic valve lesions.