Bentall procedure or Bentall surgery is an operation performed to correct the malfunctioning of the aorta. It is a surgery of the heart which involves compound replacement of the aortic root, aortic valve and ascending aorta, with re-insertion of the coronary arteries in to the new attachment or graft. It is a surgery done to repair the faulty aortic valves. The surgery involves mainly three structures i.e. Aorta, the valves and coronary artery.
Anatomy of Aorta
Aorta is largest artery of the body which emerges from the heart and is divided into the aortic root, ascending aorta, aortic arch, descending aorta and the abdominal aorta. The aortic root is the part which emerges immediately from the heart; the ascending aorta is the part which moves upwards after the aortic root; the aortic arch is the curved part which continues to the descending aorta and finally abdominal aorta. The entire aorta is divided into various smaller arteries, which supply blood to the entire body. The coronary arteries are the first pair of arteries which branches out of the aorta and supplies blood to the heart muscles. The valves are the closures which ensure one way flow of the blood i.e. from heart to aorta and rest of the body.
Why is the Bentall Surgery Needed?
Aorta faces many problems in receiving blood from the heart and distributing it throughout the body. It becomes faulty due to many reasons and risk factors. A Bentall procedure is required in the following conditions of the aorta:
Aortic Regurgitation: When the valves of the aorta create problem and they start leaking. The unidirectional flow of blood is disrupted due to the leakage.
Aortic Aneurysm: This is condition in which a particular part of the aortic increases in size due to dilation and its diameter becomes larger than the rest of the aorta. The dilated part becomes weak.
Aortic Dissection: It is result of prolonged aortic aneurysm. When the dilated part of aorta is not treated on time, it becomes weak and weak and a time comes when the walls of the aorta split causing internal bleeding and many other complications. Sometimes the death of the patient occurs even before reaching the hospital.
Marfan’s Syndrome: It is a genetic disorder in which the aortic walls are weak and becomes weaker as the age increases. Weakening of the aortic walls can cause Aortic dissection.
How Bentall Procedure is Performed?
All the above complications require Bentall procedure to correct the aortic functioning. Because it is a complex procedure, it requires general anesthesia. A cut is made at the middle of the chest to open up the heart. The heart’s activity is ceased for sometime, so that the procedure can be performed smoothly. By this time the blood flow to the body is done by a bypass machine.
The faulty part of the aorta is found and removed and the valves are checked. The faulty valves are also removed. The coronary arteries are dissected and surrounding walls of the aorta are also dissected. A synthetic graft which has a bio-prosthetic valve is stitched at the edges of the aorta. Two openings are made in the artificial graft. in which the coronary artery is fitted or sutured. The valve replacement is also done if there is any kind of leakage. The Bentall procedure surgeon checks this does the work accordingly. Once all the replacements are made, the cut which was made at the chest is stitched and bandaged. The usual time taken for the entire procedure is around 4 to 5 hours.
After the Bentall procedure surgery, all the vital activities of the body are checked by the surgeon. The recovery of the body takes 3 to 4 months. During the recovery time, the patient with Bentall procedure has to take care of certain things like avoiding rigorous activities, overeating, lifting up heavy weight etc.