Seventy seven year old father of a serving police constable came to attention for progressively increasing breathlessness on even minimal exertion. He was evaluated at a cardiac centre in Rohtak and diagnosed as a case of “Annuloaortic ectasia with severe aortic regurgitation”. This implies that the valve through which blood leaves the heart to enter the body circulation was dilated and leaking. Also, the aorta (the large artery leaving the heart) was dilated.
The patient required a Bio Bentall operation which entails replacing the aortic valve and ascending aorta and reimplanting the coronary arteries into the ascending aortic graft. A Bio Bentall procedure is surgery to help correct problems with your ascending aorta. Your aorta’s role is to carry oxygen-rich blood from your heart to the rest of your body. Ascending aorta is around 15 cm long and 2.5 cm wide, your aorta is the largest artery in your body.
Considering the patients advanced age it was not considered appropriate to use a commercially available valve conduit as it has a mechanical valve and would mandate the patient to lifelong oral anticoagulants (blood thinners).
We used a tissue valve and stitched a Dacron graft (Bio Bentall) onto it to create a composite tissue valved conduit. This composite device was used in the patient and the Bentall surgery conducted uneventfully. Patient’s post-operative recovery had been smooth and he has not require any drugs to support the heart.
We have brought attention to this case to highlight the fact that with a little attention to detail and meticulous planning very successful surgical outcomes can be achieved in old and sick patients also.