Salvage repair of complete aortic root detachment after Bentall procedure: a case of LVOT elongation

Complete detachment of the aortic root following a Bentall procedure is an exceptionally rare complication. The vast majority of reported cases are secondary to prosthetic valve endocarditis or underlying vasculitis. Currently, the most reliable treatment for aortic root dehiscence—particularly in the context of prosthetic valve endocarditis—is repeat root replacement, typically via a second Bentall procedure or with the use of a homograft or allograft. However, re-root replacement is associated with significantly higher morbidity and mortality compared to the initial operation. In cases without evidence of endocarditis or known vasculitis, augmentation of the detached aortic root using a short-segment Dacron tube graft has been shown to be a safe and effective alternative. This technique avoids the need for coronary button mobilization and reimplantation. In this presentation, we describe the surgical management of a patient who experienced complete aortic root detachment after a Bentall procedure, treated via elongation of the left ventricular outflow tract.