Bentall and Bono Surgery, Placement of Endoprosthesis in the Descending Aorta with Exlcusion of the Left Subclavian Artery and Hybrid Management of Supra-Aortic Trunks with Type I Debranching as Surgical Treatment in Aortic Dissection Stanford A/ DeBakey IA: Case Report

Document Type : Case Report

Authors

Department of Cardiac Surgery, National Medical Center ¨20 de Noviembre¨ ISSSTE, Mexico City, Mexico.

Abstract

Introduction: Bentall and Bono surgery is the procedure used in cases of aortic dissection type A of Sanford/DeBakey classification. It involves replacing the aortic root and aortic valve, placing a stent in the descending aorta, excluding the left subclavian artery, and performing hybrid management of the supra-aortic trunks with type I debranching to repair the aortic dissection and restore adequate blood flow to the aorta and the arteries that supply blood to the brain and neck.
Case Report: A 49-year-old male with a history of multivalvular cardiopathy presented with NYHA functional class I impairment. A transthoracic echocardiogram reported moderate aortic and mitral insufficiency, reduced left ventricular ejection fraction, and a thoracic aortic dissection. It was decided to perform a Bentall and Bono surgery.
Discussion: The hybrid management of supra-aortic trunks with type I debranching involve revascularization of the carotid and subclavian arteries using a technique that combines open surgery and endoprosthesis placement.
Conclusion: These procedures, although complex, allow surgeons to address both the ascending and descending aorta, preserving blood perfusion to the supra-aortic arteries and avoiding complications such as aortic rupture and heart failure.

Keywords

References

  1.  Wu Q, Lu H, Jiang D, Qiu Z, Rashid J, Xie L, et al. Early efficacy of in situ fenestration with a triple chimney technique for high‐risk Stanford type A aortic dissection: a single‐center retrospective study. Journal of Interventional Cardiology. 2021;2021(1):5662697.
  2.  Morris L, Tierney P, Hynes N, Sultan S. An in vitro assessment of the haemodynamic features occurring within the true and false lumens separated by a dissection flap for a patient-specific type B aortic dissection. Frontiers in Cardiovascular Medicine. 2022 Mar 17;9:797829.
  3. Chen YH, Shen ZY, Huang HY, Yu YS, Ye WX, Hua F, et al. Comparison of early outcome between one-stage hybrid technique and frozen elephant thunk technique in the treatment of Stanford A aortic dissection involving the arch. Zhonghua yi xue za zhi. 2021 Dec 1;101(48):3955-60.
  4. Shi F, Wang Z. Acute aortic dissection surgery: hybrid debranching versus total arch replacement. Journal of Cardiothoracic and Vascular Anesthesia. 2020 Jun 1;34(6):1487-93.
  5. Feng Y, Ren J, Zhang Y, Liu H, Ma X, Guo J. [Retracted] A Cohort Study of Surgical Indexes, Postoperative Complications, Recovery Speed, and Prognosis of Stanford Type A Aortic Dissection Compared with Traditional Sun’s Operation. Evidence‐Based Complementary and Alternative Medicine. 2022;2022(1):9516922.
  6. Bergeron P, Coulon P, De Chaumaray T, Ruiz M. Great vessels transposition and aortic arch exclusion. Journal of Cardiovascular Surgery. 2005 Apr 1;46(2):141.
Journal of Cardio-Thoracic Medicine
Volume 13, Issue 1
March 2025
Pages 1485-1489

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