[5][6] General guidelines for the repair of valvular heart disease indicate the medical team takes into consideration the following patient factors for the determination of best conduit to use: age, life expectancy, lifestyle choices (diet, exercise, hobbies, risk of potential falls/ physical trauma), medical history (history of stroke or blood clots), likelihood of surgical or transcatheter repeat procedure, and of course patient preference.
[1][7] Early Morbidity and Mortality Within 30 days of hospitalization, morbidity and mortality after Bentall procedure are associated with complications stemming from cardiac arrhythmia, pneumonia, acute respiratory distress syndrome (ARDS), sepsis, graft infection, wound infection, neurologic/ cerebrovascular accident and stroke, hemorrhage/ bleeding, myocardial infarction, pericardial effusion, organ damage/ deterioration.
[3][8] Like early morbidity and mortality, infection of a graft after Bentall Procedure is rare affecting < 5% of cases, but can be of very serious consequence to the patient.
[8][9] Many of these patients who develop infections have multiple comorbidities and risk factors existing before the surgery including diabetes, suppression of the immune system, preexisting cardiovascular issues outside of the direct indication for a Bentall procedure and cancer.
[11] Vocabulary: Endovascular procedures have been gaining popularity, especially within the last decade, due to their faster healing times and often lower risk of complications.
[14] There are several limitations of using the Endo-Bentall, including: incorporating coronary arteries, modifying TAVR devices to be better suited for treating aortic valve insufficiency and regurgitation, and addressing a need for dedicated bridging stents.
[15] Beyond the Endo-Bentall, modern literature points to some promising future directions for the repair of the ascending aorta and aortic arch, including: steerable device delivery sheaths, dedicated bridging stents, grafts that can adjust for deployability/ improved positioning, grafts with better anti-embolic protection, left ventricle wires that minimize trauma to the heart, and fusion imaging optimization.