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

Articles in Press

Document Type : Case Report

Authors

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

10.22038/jctm.2024.77569.1445

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

Journal of Cardio-Thoracic Medicine

Articles in Press, Accepted Manuscript
Available Online from 04 March 2025

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