Surgical treatment of false aneurysms following Bentall's operation

Between January 1973 and June 1993, 157 patients had Bentall's operation and its modifications for the surgical treatment of annuloaortic ectasia and dissecting aneurysm in our institute. Reoperation for false aneurysms following Bentall technique were performed 10 patients. There were 8 males and 2 females. This ages ranged from 29 to 57 years with an average of 41. The interval between initial and subsequent operation was from 3.7 to 18.4 years (median, 8.2 years). Prior to a median sternotomy, femoro vein-femoral artery partial cardiopulmonary bypass was instituted occationaly. Operative technique of repair of coronary detachment were direct closure in 6 and interposition graft technique in 4 patients. There were 2 hospital death caused by rupture at median aternotomy and graft infection. The actuarial freedom from reoperation at 10 years according to technique of coronary reattachment, for the patients with one lane suture was 69%, for those with two lane suture was 95% (p < 0.01), and for those with interposition graft technique was 100%. In conclusions, it was very important for repair of false aneurysms following Bentall procedure to expose aneurysms safely through proper approach. Interposition graft technique was preferable to repair coronary detachment. Our recent surgical results of Bentall procedure improved by the modification of the coronary reimplantation method.