The Bentall procedure is open-heart surgery in which the aortic valve, the aortic root and the first part of the ascending aorta are replaced with a single composite graft. Surgeons consider it when the aortic root is dilated and the valve is also faulty, aiming to lower the risk of aortic rupture and correct valve leakage or narrowing. The treating team decides whether it suits each patient.
It is performed under general anaesthesia through an incision in the breastbone, with a heart-lung machine. The surgeon removes the diseased valve and dilated aorta, inserts a graft carrying a mechanical or biological valve, and reattaches the coronary arteries to it. The valve type depends on age, the patient's condition and the team's judgement.
Surgery usually takes four to six hours, followed by a day or more in intensive care and about a week to ten days in hospital. Recovery is usually complete within six to twelve weeks. A mechanical valve requires lifelong blood thinners under medical supervision, with regular follow-up.
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It may lower the risk of aortic rupture or dissection and treat aortic valve leakage or narrowing, easing symptoms such as breathlessness and tiredness. The doctor estimates the likely benefit according to each patient's condition.
A patient with a dilated aortic root and a faulty aortic valve, as in some inherited connective tissue conditions or a bicuspid valve. The surgeon and cardiologist decide after an echocardiogram and other tests, with a coronary angiogram when needed.
Blood tests, an echocardiogram, a CT or MRI scan and an assessment of the coronary arteries are performed, and medication is reviewed. No drug, especially a blood thinner, may be stopped except on the doctor's instructions. Stopping smoking and treating any dental infection are advised, and fasting is required before surgery.
After general anaesthesia, the surgeon opens the chest through the breastbone and connects the patient to a heart-lung machine. The valve and the dilated section are removed, a composite graft containing the valve is sutured in, and the openings of the coronary arteries are moved to it. The chest is then closed, leaving temporary drainage tubes.
The patient usually spends one to three days in intensive care and then several days on the ward. Breathing exercises and gradual walking are advised, and lifting heavy loads and driving should be avoided for several weeks. The doctor decides when to return to work and sport.
Many patients feel gradual improvement over weeks to months. A mechanical valve is designed to last a long time, whereas a biological valve may wear out over the years and sometimes need replacing, which regular follow-up can detect.
They may include bleeding, infection, heart rhythm disturbances, blood clots, stroke, kidney failure and lung problems, and some patients need a pacemaker or repeat surgery. This is major surgery with serious risks, which the surgeon explains beforehand according to your condition.
Yes. It leaves a vertical scar in the middle of the chest and small marks where the drainage tubes were, which fade over time to a degree that differs from person to person.
A stay of at least two to three weeks is usually advised, and the treating doctor confirms the travel date after examination and imaging. The doctor may also give specific advice for long journeys.
Yes, if a mechanical valve is implanted: an oral blood thinner is needed for life, with regular blood tests to monitor clotting. Never stop the drug on your own, as only the doctor adjusts it. With a biological valve, a shorter course is often enough, as the doctor decides.
