International Journal of the Cardiovascular Academy (Jan 2020)
Modified bentall and de bono surgery: Experience in a national hospital of Peru
Abstract
Context: Modified Bentall and De Bono Surgery is the surgical treatment of choice for cardiac pathologies related to the aortic valve, aortic root, and ascending aorta. Aims: The aim of this study is to review and analyze the short- and long-term results with the Modified Bentall and De Bono technique in the Cardiac Surgery Service of a Peruvian National Hospital. Settings and Design: A retrospective study was conducted from April 2000 to July 2019. Subjects and Methods: The main variables studied were grouped into preoperative, operative, and postoperative; also, the Kaplan–Meier survival curve was used to analyze the short- and long-term survival of patients undergoing this kind of surgery. Results: During the study period, 46 patients (male, 89.13% vs. female, 10.87%; mean age: 57.52 ± 19.5 years) underwent Modified Bentall and De Bono surgery with the main operative diagnosis of anuloaortic ectasia and aneurysm of ascending aorta (52.2%). The overall mortality rate associated with surgery was 56.51% (intraoperative, 13.04%; early, 17.39%; and late, 26.08%). In the analysis of the short-term survival, 50% of patients deaths in the early period (≤30 days) occurred in an average of 5.76 days, mainly due to hemodynamic disorders (37.5%); similarly, 50% of patients deaths in the late period (≤30 days) occurred in an average of 3.88 years, mainly due to stroke (41.67%). Cumulative long-term survival rates at 5 years of 71.87%, at 10 and 15 years of 62.5% are reported. Conclusions: Despite having found unsatisfactory numbers that are slightly distant from those reported in the rest of the world, our study has described an initial experience, allowing us to identify a series of factors and opportunities that will serve as a reference to improve the critical points of surgical interventions and the perioperative management of patients with this technique.
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