Concomitant Bentall operation plus aortic arch replacement surgery

Han Chin Tsai, I. Ming Chen, Yuan Chen Hsieh, Chun Che Shih, Po Lin Chen, Wei Yuan Chen, Zen Chung Weng, Hsiao Huang Chang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The Bentall operation is recommended for thoracic aortic dissection or aneurysm involving the aortic root. However, if the lesion extends to the aortic arch, concomitant Bentall operation plus aortic arch replacement (CoBAAR) surgery is required. CoBAAR is challenging because of its complex cardiopulmonary procedure, prolonged cardiopulmonary bypass time, and demanding operative techniques. Therefore, surgical mortality and morbidity rates for CoBAAR are very high. However, the Bentall operation performed as a single procedure may lead to reoperation if the residual aneurysm progresses. Therefore, CoBAAR as a one-stage surgery can lower the need for reoperation and possible further complications. Methods: Nine patients received CoBAAR during January 2005 to May 2010. Six patients were diagnosed with Sanford type A aortic dissection and three with nondissecting ascending aortic and arch aneurysm. Four patients received a Bentall operation plus hemiarch replacement. The others received a Bentall operation plus total arch replacement along with elephant trunk because of extensive lesions. Results: The in-hospital mortality was 11.1% (1 patient with total arch replacement). Morbidity included stroke (2 patients), spinal cord injury (1 patient), mechanical ventilation for more than 72 hours (5 patients), and temporary renal dialysis (3 patients). Eight patients survived. Conclusion: CoBAAR is a demanding operative technique requiring complex cardiopulmonary bypass. However, surgeons can perform this procedure on extensive ascending aortic dissection or aneurysm patients, achieving satisfactory results.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalJournal of the Chinese Medical Association
Volume76
Issue number2
DOIs
Publication statusPublished - Feb 2013

Fingerprint

Thoracic Aorta
Dissection
Cardiopulmonary Bypass
Reoperation
Aneurysm
Morbidity
Thoracic Aortic Aneurysm
Aortic Aneurysm
Operative Time
Hospital Mortality
Spinal Cord Injuries
Artificial Respiration
Renal Dialysis
Stroke
Mortality

Keywords

  • Aneurysm
  • Aorta
  • Arch
  • Bentall
  • Dissection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tsai, H. C., Chen, I. M., Hsieh, Y. C., Shih, C. C., Chen, P. L., Chen, W. Y., ... Chang, H. H. (2013). Concomitant Bentall operation plus aortic arch replacement surgery. Journal of the Chinese Medical Association, 76(2), 88-94. https://doi.org/10.1016/j.jcma.2012.10.007

Concomitant Bentall operation plus aortic arch replacement surgery. / Tsai, Han Chin; Chen, I. Ming; Hsieh, Yuan Chen; Shih, Chun Che; Chen, Po Lin; Chen, Wei Yuan; Weng, Zen Chung; Chang, Hsiao Huang.

In: Journal of the Chinese Medical Association, Vol. 76, No. 2, 02.2013, p. 88-94.

Research output: Contribution to journalArticle

Tsai, HC, Chen, IM, Hsieh, YC, Shih, CC, Chen, PL, Chen, WY, Weng, ZC & Chang, HH 2013, 'Concomitant Bentall operation plus aortic arch replacement surgery', Journal of the Chinese Medical Association, vol. 76, no. 2, pp. 88-94. https://doi.org/10.1016/j.jcma.2012.10.007
Tsai, Han Chin ; Chen, I. Ming ; Hsieh, Yuan Chen ; Shih, Chun Che ; Chen, Po Lin ; Chen, Wei Yuan ; Weng, Zen Chung ; Chang, Hsiao Huang. / Concomitant Bentall operation plus aortic arch replacement surgery. In: Journal of the Chinese Medical Association. 2013 ; Vol. 76, No. 2. pp. 88-94.
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