Full-size Left-side Hidden

Richard J. Shemin

      In 1968, Bentall and De Bono[1] described a technique for composite aortic valve and root replacement with reimplantation of the coronary arteries. The coronary arteries were sewn to the graft as a side-to-side anastomosis, and the aneurysm wall was wrapped around the graft.
      During the ensuing years this technique underwent various modifications, primarily because of pseudoaneurysm formation at the side-to-side anastomosis of the coronary button to the graft.
      The Bentall operation currently uses a technique for treating combined disease of the aortic valve and aortic root with a button Bentall operation, a modification of the original technique described by Kouchoukos and coworkers in 1991.[2]
      All operations are performed by creating an open distal anastomosis when there is an inadequate cuff of normal aorta below the cross-clamp or by replacing the entire arch during a period of deep hypothermic circulatory arrest.
      The modified Bentall procedure …