P220. Modified Bio-Bentall Operation with a Rapid Deployment Valve
Asan Medical Center
South Korea - Contact Me
Hyo Kyen Park, MD
Dr. Hyo Kyen Park was born in Gwangju, Korea.
From a young age, Dr. Park was fascinated by the human body and how it worked. And he was interested in science and found it interesting to apply scientific theories organically and mechanically in the human body.
He is a graduate of Cheonnam national University School of Medicine, where he also attended his undergraduate studies, where graduated with a Bachelor of Chemistry.
After graduation, Dr. Park had spent 3 years as a director of local health center.
During this time, Dr. Park studied USMLE step 1 and step 2 CK and passed step 1 and step 2 CK. Also, he majored in statistics and had a Bachelor's degree in statistics from the Korea Communications University.
Dr. Park is currently training at the department of cardiothoracic surgery, Asan medical center in Seoul, Republic of Korea.
His interest in cardiac surgery and he decided that he wanted to pursue a career in developing life saving procedure.
He takes great pride in the care provided by the Cardiothoracic surgery team at the Asan medical center.
He is passionate about learning and has a medical passion and interest in sharing knowledge. He is a person who is grateful for the opportunity given in the process, and is also a doctor who is grateful for the fact that he can help patients based on his learning.
Description
While the Bentall operation is regarded as the standard therapy for aortic root surgery, it poses challenges in cases of vulnerable aortic tissue, such as infective endocarditis, Behcet's disease, or acute aortic dissection. These conditions are associated with an increased risk of prosthesis detachment, leading to significant morbidity and mortality. In this study, we present a modified Bio-Bentall technique using a rapid deployment valve (RDV).
Case video summary
After establishing cardiopulmonary support and aortic cross-clamping, the aortic roots were resected to the level of the aortic valve annulus, and coronary buttons were mobilized. A 30-mm Valsalva graft was folded and inserted into the left ventricular outflow tract, followed by a double-layer continuous suture. The graft was withdrawn, and valve size was decided. After successfully anastomosing the left coronary artery, the RDV was introduced, guided by the suture, and carefully deployed to ensure the expandable frame was positioned below the proximal end of the graft.
Surgery was performed in 13 patients (median age 69 years, IQR 67-75) by a single surgeon between January 2018 and December 2022. The median cardiopulmonary bypass time and aortic cross-clamping time was 99.0 minutes (IQR 81-120), and 73.0 minutes (IQR 60-90), respectively. Among these, 5 (38.5%) required emergent or urgent operations. There were no early mortality. Over a 10-month period of echocardiographic follow-up (IQR 6-13), no prosthetic aortic valve insufficiency was observed.
Conclusions
Our initial experiences with the modified Bio-Bentall operation using a RDV have demonstrated positive early outcomes in high-risk candidates. However, these results should be further validated with larger datasets and long-term follow-up data.
Authors
Hyo Kyen Park (1), Hong Rae Kim (2), Byeong A Yoo (3), Joon Bum Kim (4)
Institutions
(1) Asan Medical Center, Seoul, (2) Asan Medical Center, Gangnamgu, Seoul, (3) Asan medical center, Seoul, Korea, Republic of, (4) Asan Medical Center, Seoul, Na