Long-term results of modified Bentall procedure using flanged composite aortic prosthesis and separately interposed coronary graft technique

We have selected the flanged composite aortic prosthesis and separately interposed coronary graft technique for the aortic root replacement over seven years. We sought to evaluate the long-term results of aortic root replacement with this technique. Between April 1996 and September 2003, 71 patients (mean age 46.1+/-12.9 years, 67.6% males) underwent aortic root replacement with this technique. Sixty-two patients had annuloaortic ectasia, and seven patients acute type A aortic dissection. Marfan syndrome was recognized in 35 patients. Two separate 8-10 mm knitted Dacron grafts were interposed between a valved composite graft and both coronary ostia to avoid kinking of coronary arteries. The early mortality rate was 4.2%. The actuarial survival rate was 93.9+/-3.0% at 5 years. The freedom from operation related complications was 86.7+/-4.1% at 5 years. No patients had anticoagulant-related hemorrhage, valve thrombosis, reoperation, graft thrombosis, or coronary pseudoaneurysm. The separately interposed coronary graft and the flanged composite graft technique is predictable and safe. Coronary pseudoaneurysm and graft thrombosis have been eliminated.