What is Bentall Procedure ?
Bentall procedure is a type of heart surgery that helps to address aorta issues. Your aorta transports oxygen-rich blood from your heart to the rest of your body. Your aorta is the largest artery in your body, measuring roughly 30 centimeters long and 2.5 centimeters wide.
The Bentall procedure involves composite graft replacement of the aortic valve, aortic root, and ascending aorta, with re-implantation of the coronary arteries into the graft. This operation is used to treat combined disease of the aortic valve and ascending aorta, including lesions associated with Marfan syndrome.
The procedure is named for Hugh Bentall, who first performed and described it in 1968.
Purpose of the Bentall Procedure
A multitude of medical conditions can cause difficulties with the aorta and aortic valve. Marfan syndrome, a hereditary disease that affects a person's connective tissue, including some of the tissues in the aortic root and valve, is one of the most common problems.
A person with Marfan syndrome may develop an aneurysm in their ascending aorta, in addition to other medical issues. (An aneurysm is a weakening of the artery wall that causes the artery to bulge or distend. The majority of aneurysms have no symptoms and are not hazardous. Some, however, can burst at their most severe stage, resulting in life-threatening internal bleeding).
In addition to other potential medical problems, a person with Marfan syndrome might have an aneurysm form in their ascending aorta.
This can cause the artery to burst, resulting in a potentially fatal situation. Intervention, such as the Bentall technique, is required to prevent this. If an aneurysm has already ruptured, the Bentall treatment may be required as an emergency surgery.
When is Bentall Procedure required?
The Bentall surgery is indicated for the following conditions of the aorta:
- Aortic regurgitation - when your heart's aortic valve doesn't close properly
- Marfan's syndrome - a disease from birth that weakens the aortic wall thickness
- Aortic aneurysm - widening of the aorta
- Aortic dissection - when the inner layer of the aorta tears
An aortic root aneurysm might not always require surgical correction (such as a Bentall procedure). The benefits of surgery must be weighed against the risks of not having surgery.
How is Bentall Procedure done?
Bentall surgery is done under general anesthesia and takes about 4-5 hours. You are connected to a heart-lung bypass machine during the operation on the heart and adjacent structures. This equipment can do the functions that your heart and lungs regularly perform. This enables the surgeon to momentarily halt your heart while he or she works on the aorta and its valve.
Step 1
The surgeon will make a cut in your chest, through the breastbone, to access the aortic valve and the aorta.
Step 2
The surgeon will clamp the aorta and remove the damaged section of the aorta and valve. Then the surgeon will replace that part of the aorta with a prosthetic tube (called a graft).
Step 3
The surgeon will surgically connect one end of the graft to your remaining, normal aorta. The other end containing the valve is also sewn into the heart. The surgeon will also need to sew the coronary arteries (that bring blood to the heart itself), to make sure they receive adequate blood flow after the operation.
What is the Recovery after Bentall Procedure like?
You'll be transferred to the intensive care unit for a day or two and connected to a ventilator, where your vitals will be monitored. You would then be shifted to your room where you would stay for 5-6 days under medical supervision. Your doctor will give you a list of instructions to follow before you are released, such as:
- Gradually increase your exercise as tolerated.
- For up to 12 weeks after surgery, avoid any strenuous activities.
- For the first few weeks after surgery, avoid lifting any heavy weights.
What Results Can I Expect from Bentall Procedure?
Bentall surgery has an exceptional outcome and gives extremely satisfying results. Majority of patients who undergo the procedure return to normal activities after the operation.
