Bentall and Bono Surgery, Placement of Endoprosthesis in the Descending Aorta with Exlcusion of the Left Subclavian Artery and Hybrid Management of Supra-Aortic Trunks with Type I Debranching as Surgical Treatment in Aortic Dissection Stanford A/ DeBakey IA: Case Report

Introduction: Bentall and Bono surgery is the procedure used in cases of aortic dissection type A of Sanford/DeBakey classification. It involves replacing the aortic root and aortic valve, placing a stent in the descending aorta, excluding the left subclavian artery, and performing hybrid management of the supra-aortic trunks with type I debranching to repair the aortic dissection and restore adequate blood flow to the aorta and the arteries that supply blood to the brain and neck.Case Report: A ۴۹-year-old male with a history of multivalvular cardiopathy presented with NYHA functional class I impairment. A transthoracic echocardiogram reported moderate aortic and mitral insufficiency, reduced left ventricular ejection fraction, and a thoracic aortic dissection. It was decided to perform a Bentall and Bono surgery.Discussion: The hybrid management of supra-aortic trunks with type I debranching involve revascularization of the carotid and subclavian arteries using a technique that combines open surgery and endoprosthesis placement.Conclusion: These procedures, although complex, allow surgeons to address both the ascending and descending aorta, preserving blood perfusion to the supra-aortic arteries and avoiding complications such as aortic rupture and heart failure.

Keywords:

aorta , Debranching , Dissection , Endoprosthesis , Hybrid