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How to replace a bioprosthetic aortic valve within the Bentall graft
Author(s) -
Beliaev Andrei M.,
Haydock David A.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14419
Subject(s) - medicine , bentall procedure , cuff , aortic valve , surgery , electrical conduit , annulus (botany) , cardiac skeleton , fibrous joint , stent , commissure , aortic valve replacement , aortic root , aorta , cardiology , anatomy , stenosis , mechanical engineering , botany , engineering , biology
The Bentall procedure using a bioprosthesis‐containing conduit carries the risk of structural valve deterioration within the patients’ lifetime. Failed aortic bioprosthesis replacement requires a redo aortic root replacement that is associated with significant morbidity and mortality. We describe an original “neo‐annulus” technique of aortic valve replacement (AVR) within the Bentall graft. This technique involves an incision of the Bentall valve‐containing aortic root conduit, cutting the stainless wireform stent and the inner plastic stent of the bioprosthetic valve at the tips of commissure posts with a wire cutter, removal of semilunar fragments of the remaining stainless wire, division of the fabric of the valve between the valve sewing cuff and the Elgiloy alloy base ring leaving the sewing cuff of the excised aortic valve bioprosthesis attached to the Bentall conduit as a “neo‐annulus”. Subsequently, this neo‐annulus is stitched with interrupted 2/0 Ticrone sutures and another prosthetic aortic valve implanted inside of the old Bentall conduit. The graft incision is closed with a continuous 4/0 polypropylene suture.