Short-term outcome of a new modification of the Bentall operation: Carrel patch and inclusion technique.

Leakage around the coronary ostia continues to be the major complication of composite graft replacement of the ascending aorta and aortic valve. To reinforce coronary anastomosis and reduce the operating time, a new modification of the Bentall operation was developed. This procedure involves dissecting full-thickness coronary buttons while leaving the epicardium on the aortic wall and complete wrap of the composite graft by the tailored aortic wall (Carrel patch and inclusion technique). Since March 1983, this approach has been performed in 12 patients (group A) and other Bentall-type operations in 22 (group B). Time affected by haemostasis was 28 min less in group A than in B (P = 0.23). Blood loss and blood transfusion during surgery and hospitalization were significantly lower in group A than B. Significantly less leakage occurred in group A than in B. On the basis of these short-term results, the Carrel patch and inclusion technique is considered to be an accurate time- and blood-saving procedure.