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Bentall Surgery
- Days In Hospital 7 days
- Outside Hospital Stay 30 days
- Success Rate 90%
Minimum Cost
$ 7000
Maximum Cost.
$ 15000
Overview of Bentall Surgery in India
The aorta is the largest vessel in the human body. Its primary function is to transport blood and other vital substances from the heart to the rest of the body, making it a vital component of the human body's functioning. The Bentall procedure is an open-heart surgery that is used to repair or replace damaged parts of the aorta, including the aortic root and valve, that occur because of an aortic aneurysm.
An aortic aneurysm occurs when the walls of the aorta develop a bulge. In some cases, the walls of these aneurysms can rupture or tear and cause bleeding internally or obstruct the flow of blood from the heart to the other organs of the body. Such cases are life-threatening.
The Bentall procedure was first performed by Hugh Bentall and Antony De Bono in 1968. The procedure consists of replacing the aortic valve and ascending aorta with a composite graft made of both artificial and biological materials and re-implanting the coronary arteries back into the composite graft.
Recovery from the Bentall procedure varies greatly depending upon the patient, but can take anywhere from weeks to several months to fully recover after the surgery is completed.
What is the Bentall Procedure?
The Bentall procedure tackles some of the toughest heart problems—mainly issues with the aortic root and aortic valve. These parts keep blood flowing out of your heart and into your body. When they go bad, like with a ballooning aorta or a leaky valve, things can get dangerous fast.
People with conditions like Marfan syndrome, aortic aneurysm, valve disease, or an aortic dissection (that’s when the aorta tears) often end up needing this surgery.
So, what actually happens during a Bentall procedure? Here’s the gist.
Surgeons open the chest and swap out three things all at once: the aortic valve, the aortic root, and the ascending aorta. Doctors call this a “composite graft replacement.” Dr. Hugh Bentall and his team first came up with the operation back in 1968. Their goal was simple—fix everything in one go for patients whose valves and aorta were both in trouble.
Why is this surgery a big deal?
First, the bad aortic valve gets replaced with a mechanical or biological one. Then, the surgeon takes out the damaged part of the aorta and puts in a synthetic graft. They even reattach the coronary arteries so the heart keeps getting the blood it needs. It’s a bit like ripping out an old, busted pipe and valve system in your house and putting in brand new parts—only way more important.
Types of Bentall Surgery:
Traditional Bentall Procedure
The traditional Bentall Procedure is performed using an artificial graft to replace both the aortic valve and the ascending Aorta. A mechanical or biological valve is used with a synthetic graft to replace the diseased aorta. The cost for this procedure ranges from 7,000 to 9,000 USD.
Modified Bentall Procedure
Modified Bentall Procedure is similar to the above procedure, but there may be some variations in the technique used (i.e. different suture techniques/graft materials). The basic procedure to replace the aortic valve and ascending aorta remains the same as in the traditional Bentall procedure. The cost for this procedure ranges from 7,000 to 10,000 USD.
Button Bentall Procedure
Button Bentall Procedures (also known as Button Bentalls) use button-like flaps to re-attach the branches of the aorta into the graft when replacing the aortic valve and ascending aorta with an artificial graft. By doing so, this procedure improves blood flow to certain branches of the aorta while decreasing your chances of complications. The cost of the button-bentall procedure ranges from 8,000 to 13,500 USD.
Hemashield Bentall Procedure
This type of procedure will utilise a specific graft material known as Hemashield as the synthetic tube graft. This graft material was created to help reduce the possible chance of developing infection or other complications related to using this graft. The price range for this procedure is $7,000 - $11,500.
Valve-Sparing Bentall Procedure
This procedure does not fit the definition of a "true" Bentall procedure in the traditional sense. This procedure involves the replacement of the aorta and the preservation of the patient's aortic valve; this is sometimes referred to as the "David procedure" or re-implantation procedure. The cost of this procedure ranges from $9,000 - $13,000.
Bioprosthetic Valve Bentall Procedure
This type of procedure will use a bioprosthetic (tissue) valve as opposed to a mechanical valve. This type of valve is derived from animals and does not require medications to limit the incidence of possible complications associated with the use of this type of valve. The price range for this procedure is $9,500 - $14,000.
Procedure:
Before the surgery
- The patient will be informed about all the risks and complications that lie in the course of this procedure.
- To establish the best location where wires should be placed in DBS, several imaging scans are to be undertaken, such as the Magnetic Resonance Imaging (MRI), and the Computed Tomography (CT-Scan).
- Disclose to the doctor any past infection, injury, or surgery around the genitals or the groin.
- Report to the doctor a list of the medications taken by the child, including her taking herbal supplements.
- Anti-inflammatory drugs and aspirin should also be avoided since they are likely to cause increased bleeding.
- The physician provides information on the timing of taking a shower and to prepare the procedure.
- Selection of the valve Bentall procedure. The valves are chosen between mechanical replacement of valves and valve replacement is done using synthetic or biological material. All of them have both strengths and weaknesses. The mechanical valves are quite durable and long-lasting. The patient must however life long to be on anticoagulant therapy to prevent the occurrence of a blood clot at the replacement site that is being replaced. Synthetic biological valve replacement, on the other hand, is not long-lasting and needs a follow-up surgery. Nevertheless, no anticoagulant therapy is required for the patient with such a replacement.
During the procedure
Anaesthesia: Firstly, general anaesthesia is given to the patient in order to make him/her experience no pain.
Catheter and Ventilator Placement: This will be followed by the insertion of a catheter by the doctor to gather the urine output during and after the surgery. The patient will also bear a special tube close to the airway, which will be attached to a ventilator.
Heart-Lung Bypass Machines: When all preparations are complete, the surgeon will open the chest area and reach the aortic valve and the aorta.
Aorta and Valve replacement with Prosthetic Graft: The surgeon will then clamp on the aorta and remove the damaged parts and aortic valve, and the surgeon will replace that aortic part with a tube made of plastic known as a graft. There is an artificial aortic valve in this graft that could be mechanical or synthetic biological tissue.
Connections of the Graft to the Remaining Aorta and Heart: One end of the graft will be surgically attached to the remaining normal aorta, but the other end, where the valve is located, will be connected to the heart through sewing. The physician will also be required to connect with the neighbouring coronary arteries that assist in directing the blood back to the heart so that they obtain sufficient blood flow following the surgery.
Clamp Removal and Blood Flow Restoration: When everything has been sorted out the clamp may be removed subsequently. The patient will next be taken off the heart-lung machine, and the heartbeat will be re-initiated when blood starts pumping through the artificial valve and graft and to the rest of the body.
Closure of Sternum and Incision Site: Lastly, the surgeon will now close the sternum through the assistance of an incision over the area of the chest.
After the Procedure
- Surely the patient has an endotracheal tube and a chest tube that drains the extraneous fluids and air following surgery.
- Surgery complications are observed over night closely in the ICU or recovery room of the patient in case of any complications like blood clots.
- Diet and beverage consumption are generally restored on the first day after the operation, and then the patient is transferred to a general or private ward after another day or two in the ICU.
- Depending on the situation, patients are observed when it comes to bowel movements and can be discharged with catheters and chest tubes after a course of a few days.
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Cost of Bentall Surgery in India
Costs for a Bentall operation will typically fall within the range of $8 000 to $15 000, depending on many factors, including the patient's medical status, the type and quality of facility performing the surgery, and the experience level of the surgeon performing the resection. The specific type of valve being used to replace their aortic valve will also affect the overall cost of the procedure; other factors include gender (women generally have higher overall heart disease rates than men) and the type of cardiac rehabilitation program following discharge from the hospital after surgery.
City-Wise Variations of Bentall Surgery Cost in India
Delhi: 8000 to 12,000 USD
Mumbai: 9000 to 15,000 USD
Chennai: 7000 to 11000 USD
Noida: 7500 to 10500 USD
Bangalore: 8500 to 11,000 USD
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Indications of Bentall Surgery:
Bentall surgery comes into play when someone’s dealing with serious aortic problems— the kind that can turn deadly fast. Here’s why doctors usually recommend it:
Aortic Root Aneurysm
This happens when the section of the aorta near the heart swells up like a balloon. If it pops, it’s often fatal on the spot.
Aortic Valve Disease
Sometimes the aortic valve gets leaky (that’s regurgitation) or stiff and narrow (that’s stenosis). Either way, the heart has a tough time pumping blood the way it should.
Connective Tissue Disorders
Things like Marfan syndrome or Loeys-Dietz syndrome mess with the strength of the aorta. The wall gets weak, making it easier for it to tear or bulge.
Aortic Dissection
This is as bad as it sounds—a rip forms in the aorta’s wall. It’s an emergency, and the only real fix is surgery, fast.
Symptoms
The way the aorta's lumen behaves impacts the development of aortic wall problems. Initially, the heart compensates for the problem by enlarging, which can take several years. Most people will not experience symptoms for several years and may not know they have an aortic wall problem. Once the aortic valve or wall becomes compromised, however, a person will experience many symptoms, including:
- Extreme fatigue/weakness
- Difficulty breathing
- Minimal ability to engage in strenuous activities
- Chest discomfort
- Pressure/discomfort within the chest
- Faintness/lightheadedness
- Irregular heartbeat
- Fast/irregular heartbeat
- Heart murmur
Risk Factors:
The Bentall operation has its share of difficulties, as is the case with many open-heart surgeries. The following are some of the potential issues that could arise:
- Heart attack and stroke
- Abrupt renal failure
- decreased cardiac output
- infection, such as pneumonia, sepsis, etc.
- Internal bleeding
- thrombi in the legs or lungs
- Rarely, death