Mid-term outcome and quality of life after Bentall procedure: single-center experience

Main Article Content

I. O. Stetsyuk
L. R. Stetsiuk
B. M. Todurov
I. Yu. Mokryk
V. I. Zaviiskyi
I. P. Nechai
V. B. Demyanchuk
O. V. Zelenchuk

Abstract

The aim – to evaluate the mid-term results and quality of life of patients who underwent Bentall procedure.
Materials and methods. The research included 55 patients who underwent planned surgical treatment at the Heart Institute of Ministry of Health of Ukraine from 2015 to 2023. The mean age of the 55 patients (53 (96.36 %) males), who underwent the Bentall procedure (composite graft replacement of the aortic root), was 52.36 ± 1.56 years. We analyzed basic characteristics of the patients, intraoperative and postoperative data. The quality of life was assessed before and in the mid-term period after operations by the Medical Outcomes Study Short Form 36 (MOS SF-36) questionnaire.
Results. An average duration of the follow-up period was (3.61 ± 0.28) (СІ 3.05–4.16) years ranging from 1.0 to 9.0 years. Overall, in-hospital mortality and 30-day mortality was 1.89 % (n = 1). The only case of death was caused by the acute respiratory distress syndrome. The 5-year survival rate was 94.61 ± 3.10 % for all patients. It is reasonable to say that all 3 cases of death were due to a non-cardiac cause, i.e. stroke, malignancy and acute abdomen. The average duration of the operations was 244.48 ± 7.67 minutes, the total duration of artificial blood circulation was 138.73 ± 6.47 minutes, aorta clamping time – 95.82 ± 4.79 minutes. The mean duration of hospital staying was 16.98 ± 0.91 days, intensive care unit – 4.84 ± 0.33 days. The number of patients extubated up to 8 hours after surgery was 41 (74.55 %) patients. The operation significantly improved parameters of the quality of life. 
Conclusions. Patients after Bentall procedure have low overall in-hospital mortality and 30-day mortality 
(1 (1.89 %)). The 5-year survival rate was 94.61 ± 3.10 %. All three case of death during follow-up period were due to non-cardiac causes. Excellent mid-term results prove that Bentall procedure must be a routine surgery for patients with aortic root aneurysm, mixed aortic valve pathology and anatomically altered aortic valve leaflets. The operation significantly improved quality of life of patients in all domains.

Article Details

Keywords:

quality of life, Bentall procedure, aortic valve, ascending aorta, aortic root aneurysm, aortic aneurysms, valvular pathology

References

Todurov B, Stetsyuk I, Zelenchuk O, Mokryk I, Stetsiuk L, Demyanchuk V, Malova N. The valve-sparing aortic root replacement: Results of the David I technique. Cardiac Surg. Intervent Cardiol. 2024;13(1):62-7. https://doi.org/10.31928/2305-3127-2024.1.6267. DOI: https://doi.org/10.31928/2305-3127-2024.1.6267

David TE. Aortic valve repair and aortic valve-sparing operations. J Thorac Cardiovasc Surg. 2015;149(1):9-11. https://doi.org/10.1016/j.jtcvs.2014.10.052. DOI: https://doi.org/10.1016/j.jtcvs.2014.11.019

Coady M, Rizzo A, Hammond G, Kopf G, Elefteriades J. Surgical intervention criteria for thoracic aortic aneurysms: a study of growth rates and complications. Ann Thorac Surg. 1999;67(6):1922-58. https://doi.org/10.1016/S0003-4975(99)00358-1. DOI: https://doi.org/10.1016/S0003-4975(99)00431-2

Leontyev S, Schamberger L, Davierwala PM, et al. Early and Late Results After David vs Bentall Procedure: A Propensity Matched Analysis. Ann Thorac Surg. 2020;110(1):120-6. https://doi.org/10.1016/j.athoracsur.2019.11.050. DOI: https://doi.org/10.1016/j.athoracsur.2019.10.020

Rashid HN, Chehab O, Hurrell H, Androshchuk V, Sularz A, Patterson T, et al. Conventional aortic root vs valve-sparing root replacement surgery in aortic dilatation syndromes: a comparison of mortality and postoperative complications. Expert Rev Cardiovasc Ther. 2023;21(1):57-65. https://doi.org/10.1080/14779072.2023.2164356. DOI: https://doi.org/10.1080/14779072.2023.2162039

Ničovský J, Ondrášek J, Černý J, Žáková D, Němec P. Chirurgická léčba aneuryzmatu aortálního kořene: srovnání Bentallovy operace a reimplantace aortální chlopně podle Davida [Surgical treatment of aortic root aneurysm: comparison of Bentall procedure and David reimplantation of aortic valve]. Vnitr Lek. 2017;63(10):640-5. https://doi.org/10.36290/vnl.2017.126. DOI: https://doi.org/10.36290/vnl.2017.126

Schamberger L, Leontyev S, Davierwala PM, Von Aspern K, Lehmann S, Misfeld M, et al. David aortic valve-sparing reimplantation versus biological aortic root replacement: a retrospective analysis of 411 patients. Indian J Thorac Cardiovasc Surg. 2020;(Suppl 1):97-103. https://doi.org/10.1007/s12055-019-00852-7. DOI: https://doi.org/10.1007/s12055-019-00873-4

Stetsyuk I, Todurov B, Zelenchuk O, Stetsiuk L, Mokryk I, Zaviiskyi V. Quality of life of patients treated by valve-sparing aortic root replacement. Clin Prev Med. 2024;(3):21-6. https://doi.org/10.31612/2616-4868.3.2024.03. DOI: https://doi.org/10.31612/2616-4868.3.2024.03

Sterian AG, Ulici A. Quality of life after flatfoot surgery in the pediatric population. J Med Life. 2020;13(3):356-61. https://doi.org/10.25122/jml-2020-0144. DOI: https://doi.org/10.25122/jml-2020-0144

Cummins RA. Understanding quality of life in medicine: A new approach. J Am Coll Nutr. 2015;34(Suppl 1):4-9. https://doi.org/10.1080/07315724.2015.1080091. DOI: https://doi.org/10.1080/07315724.2015.1080099

Hamiko M, Jahnel K, Rogaczewski J, Schafigh M, Silaschi M, Spaeth A, et al. The long-term outcome and quality of life after replacement of the ascending aorta. J Clin Med. 2023;12(13):4498. https://doi.org/10.3390/jcm12134498. DOI: https://doi.org/10.3390/jcm12134498

Major P, Stefura T, Dziurowicz B, Radwan J, Wysocki M, Małczak P, et al. Quality of life 10 years after bariatric surgery. Obes Surg. 2020;30(10):3675-84. https://doi.org/10.1007/s11695-020-04750-z. DOI: https://doi.org/10.1007/s11695-020-04726-7

Van HD, Pham TB, Chau CL, Vuong NL. Modified Bentall procedure: A 15-year single-center clinical experience. Asian Cardiovasc Thorac Ann. 2022;30(7):779-87. https://doi.org/10.1177/02184923221122034. DOI: https://doi.org/10.1177/02184923221090692

Most read articles by the same author(s)