What question did this study set out to answer?

To evaluate surgical outcomes, survival, and reoperation rates associated with three variations of the Bentall procedure for composite aortic root replacement.

July 1, 1994Journal of Cardiac Surgery

Three Faces of the Bentall Procedure

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Why the study?

How do the outcomes of Classic, Button, and Cabrol anastomotic techniques compare in patients undergoing the Bentall procedure?

Key Points

To evaluate surgical outcomes, survival, and reoperation rates associated with three variations of the Bentall procedure for composite aortic root replacement.
Retrospective review of 140 consecutive patients undergoing Bentall operations between October 1986 and March 1994.
Comparison of three anastomotic approaches: Classic technique (n = 30), Button technique (n = 95), and Cabrol modification (n = 15).
Univariate, multivariate, and actuarial survival analyses were conducted to evaluate hospital mortality, reoperations, and late valve-related complications.
Overall hospital mortality was 5%, with acute type A dissection, rupture, neurological symptoms, and the Cabrol technique associated with higher mortality on univariate analysis, though no independent risk factors emerged on multivariate analysis.
Reoperation rates did not differ significantly among techniques (Classic 4.1%/patient-year, Button 2.7%/patient-year, Cabrol 0%/patient-year; p = 0.44), yielding an overall 5-year actuarial freedom from reoperation of 87%.
Five-year actuarial survival was 79% overall (Classic 85%, Button 82%, Cabrol 52%), and the presence of dissection significantly elevated mortality in patients with Marfan syndrome (50% vs 8%, p = 0.03).

Structured PICO

How do the outcomes of Classic, Button, and Cabrol anastomotic techniques compare in patients undergoing the Bentall procedure?

Population

140 consecutive patients who underwent Bentall operations between October 1986 and March 1994

Intervention

Bentall procedure using three different anastomotic techniques (Classic, Button, and Cabrol)

Comparator

Comparison among the three anastomotic techniques (Classic vs. Button vs. Cabrol)

Outcome

Hospital mortality, reoperation rates, and 5-year actuarial survivalhard clinical

The Button Bentall technique is recommended as the routine procedure of choice, demonstrating favorable survival and reoperation rates compared to the Cabrol variation.

Limitations

Patient selection bias in the Cabrol group
Small sample size in the Cabrol group

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports similar reoperation rates across techniques; leaves open optimal Bentall anastomotic choice pending randomized data.

Cite This Study

Mldulla et al. (1994) studied this question.

synapsesocial.com/papers/6a98e2417384e28de71feddc https://doi.org/10.1111/j.1540-8191.1994.tb00879.x

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Three Faces of the Bentall Procedure

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Three Faces of the Bentall Procedure

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider