Aortic Root Pathologies and Surgical Management: Insights From a Single Surgeon’s Experience

Introduction and objectives The Bentall procedure is a surgical technique designed to address aortic root abnormalities, including issues with the aortic valve, aortic root, and ascending aortic disease. This study aimed to assess the short-term outcomes of 39 patients who underwent the Bentall and concomitant procedures: aortic root enlargement, personalized external aortic root support (PEARS), and Mini-Bentall procedures at a single center. Methodology We conducted a retrospective study involving 39 patients who underwent surgery for aortic root pathologies such as dissection, Marfan syndrome (MFS), bicuspid aortic valve, degenerative disease, and atherosclerosis at our hospital between January 2019 and September 2024. Data were collected from clinical records and were utilized for statistical analysis. Results In this study of 39 patients (average age 43.97 ± 17.45 years; 71.8% male), hypertension was the most common risk factor (46.2%). The early mortality rate was 2.6%, with one death from bleeding. Dissection and MFS were the leading causes of aortic root pathologies (35.9% each). Coexisting heart diseases were found in 20.5% of patients. Emergency and urgent surgeries accounted for 38.5% and 53.8%, respectively. Bentall surgery was performed in 64.4% of cases, with average cardiopulmonary bypass (CPB) and cross-clamp times of 196.10 ± 25.23 and 169.05 ± 23.9 minutes, respectively. Conclusion Overall, the hospital mortality rate for the Bentall procedure at our institution was 2.6%, consistent with the reported literature. Our results show that, although complex, the classic Bentall technique can be performed safely with acceptable short-term morbidity and mortality. Addressing complications like hospital mortality and postoperative bleeding is crucial, as these issues may be preventable.