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"Biological Bentall" Procedure

Wednesday, December 3, 2014

In this video, the authors present their technique for aortic root replacement using a freestyle aortic root prosthesis and a Dacron graft, thus achieving a "Biological Bentall." This technique could be extremely beneficial for all patients requiring a classical Bentall procedure, but with specific indications for a biological solution. This video shows the full technique in a patient who also required myocardial revascularization.

The steps of the Biological Bentall technique are:

  1. Removal of the native aortic valve and the preparation of the coronary ostium. 
  2. Single suture implant of freestyle aortic root prosthesis (the authors used a continuous suture, but interrupted U-stitches with pledgets could also be used).
  3. Coronary ostium reimplantation of the freestyle aortic root.
  4. Ascending aorta replacement using a straight Dacron graft.


I reported our experience with Bentall operation using an aortic homograft valve and conduit in the year2000(THIJ,2000).Subsequently I submitted the video of this technique which was listed in the CTSnet in 2005.This technique has several advantages,apart from being a natural valve with no gradients, it is less expensive,there is little or no bleeding and no need for anticoagulation.It is still not popular among surgeons for some unknown reason.
That is the very nice technique in patients indicated for Bentall operation. It has special technical approach in implantation of Freestyle conduit, but the results are enough satisfactory. Less aortic residual gradient, less being prone to infection and less anticoagulation brings to the patients in excellent condition. I ve been experienced this technique with Dr. Amando Gamba in Bergamo, who rules currently the Cardiac Surgery Unit in Lecco, Italy. Thanks to dr. Gamba for teaching me this technique, and thanks to current Authors for excellent video!!!

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