title: Long-term results of modified Bentall procedure using flanged composite aortic prosthesis.
abstract: OBJECTIVE
  We have been using the flanged composite aortic prosthesis and Carrel button technique to re-attach the coronary ostia in aortic root replacement procedures at our institution over the last twenty five years. Our objective was to evaluate the long-term results of aortic root replacement with this technique.
  
  
  METHODS
  A total of 73 patients from January 1984 to August 2010 were included in this study. The median age was 52.7 ± 14.4 years (range 28-80 years). There were 48 male and 25 female patients. 44 patients (60.3%) had annuloaortic ectasia, and 15 patients (20.5%) had acute type A aortic dissection. Marfan syndrome was recognized in 12 patients (16.5%).
  
  
  RESULTS
  The early mortality rate was 5.5% (n = 4). Causes of death were multiple organ failures in two patients and sepsis in another two patients. The actuarial survival rate was 84.2% at 5 years, 64.3% at 15 years and 51.9% at 25 years. Only one patient with aortitis needed a reoperation because of coronary pseudoaneurysm after 23 years from the previous operation.
  
  
  CONCLUSIONS
  This modified Bentall procedure is reliable and safe, with superior long-term survival and a low rate of aortic reoperation.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tamura
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Arai
authors.forename: Satoru
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Satoru
authors.initials: S
authors.lastname: Makita
authors.forename: Naoto
authors.initials: N
authors.lastname: Miyagi
authors.forename: Taiju
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome