Bentall procedure in ascending aortic aneurysm: hospital mortality.
BACKGROUND
Ascending aortic aneurysm disease (AAAD) shows a low frequency, heterogeneous behavior, high risk of rupture, dissection and mortality, making elective surgery necessary. Several procedures have been developed, and the Bentall technique is considered as the reference standard. The objective was to describe the hospital mortality of AAAD surgically treated using the Bentall procedure.


METHODS
We carried out a descriptive study. Included were 23 patients with AAAD who were operated on between March 1, 2005 and September 30, 2008 at our hospital. Data were obtained from clinical files, and descriptive statistics were selected for analysis.


RESULTS
The study population was comprised of 23 patients with an average age of 46 years; 83% were males. Etiology was nonspecific degeneration of the middle layer with valve implication in 43%, bivalve aorta in 22%, Marfan syndrome, Turner's syndrome and poststenotic aneurysms each represented 9%, and Takayasu disease and ankylosing spondylitis 4% each. Associated heart disease was reported in six (26%) patients as follows: aortic coarctation (2), ischemic cardiopathy (1), atrial septal defect (1), severe mitral insufficiency (1) and subaortic membrane (1). Procedures carried out were Bentall surgery in 20 (87%) patients and aortoplasty with valve prosthesis in three (13%) patients. Complications reported were abnormal bleeding with mediastinal exploration (17%), nosocomial pneumonia (13%), arrhythmia (13%), and septic shock (9%). Mortality was reported in three (13%) patients due to septic shock and ventricular fibrillation.


CONCLUSIONS
Surgical mortality with the Bentall procedure is similar to published results by other specialized centers. Events related to the basic aortic pathology, surgical technique, aortic valve prosthesis and left ventricular dysfunction encourage longterm studies with follow-up.
Departamento de Cirugía Cardiotorácica, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico. mmygato@hotmail.com
Matilde Myriam
MM
Galicia-Tornell
Bertha
B
Marín-Solís
Clotilde
C
Fuentes-Orozco
Manuel
M
Martínez-Martínez
Esteban
E
Villalpando-Mendoza
Fermín
F
Ramírez-Orozco
D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000209:etiology / Q000401:mortality / Q000601:surgery; D001014:Aortic Aneurysm / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D017558:Elective Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000150:complications; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality; D014693:Ventricular Fibrillation / Q000209:etiology / Q000401:mortality; D055815:Young Adult