Advances in the field of healthcare has benefited countless patients; specifically, in the field of Cardiac Surgery has been proving advantageous to enumerable patients across the globe. Be it minimally invasive Cardiac procedures, latest Open-heart surgeries, modern therapies for Heart failure and much more – the patients with any complicated Heart ailment has a chance to get cured today. Previously, patients with many kinds of Heart conditions didn’t have much scope to get the appropriate cure but today the situation has evolved majorly, which is a huge respite for the patients.
Over the years, there have been many types of Heart diseases, which are affecting millions around the world. Furthermore, as opposed to earlier times, when most older people were affected by Cardiac ailments, today, even people belonging to the younger generation are affected by Cardiac issues. However, thanks to the undying efforts of the medical researchers and Cardiac experts, there is a wide range of new treatment and surgeries that have been invented. Owing to this, the demand for the apt Cardiac cure, despite being high, can be met. One of the very innovative Cardiac Surgeries that has taken the field of Cardiac Surgery to a level higher is the Bentall Surgery.
Overview: Bentall Procedure
Why is Aorta so important?
The Heart’s Aorta is the largest artery, which stems from the Heart and then branches into smaller arteries. These arteries are helpful as they dispense the oxygen and nutrients rich blood to all parts of the body. The first pair of arteries that branch out of the Aorta is the Coronary Arteries that supply blood to the Heart. The smooth functioning of the Aorta is extremely vital because it ensures one-way blood flow – from the Heart to the Aorta and finally to the rest of the body.
The Aorta can be segmented into four crucial sections:
- A section that rises from the Heart known as the Ascending Aorta
- Section that bends over the heart is known as the Aortic Arch
- A part that moves down the Chest region, which is known as the Descending Thoracic Aorta
- A part that begins at the Diaphragm known as the Abdominal Aorta
It is when this crucial artery suffers damage, a leakage problem or any other issue, that a surgical intervention is suggested. This is important because a faulty Aortic valve can prove fatal for the patient.
How can Bentall Surgery help?
A Bentall Surgery is focused on repairing the malfunctioning Aorta. It is an extremely intricate Cardiac surgery in which there is compound replacement of the Aortic Valve, Aortic Root, and the Ascending Aorta, with re-insertion of the coronary arteries inside the new attachment or graft.
Who are the candidates for Bentall Surgery?
The Bentall Surgery can prove extremely fruitful for patients suffering from the following Heart conditions:
- Aortic Regurgitation – When the Aortic valves create problems and being to leak and the unidirectional blood flow is disrupted
- Marfan’s Syndrome – a genetic ailment that weakens the Aortic wall and it keeps weakening with age. This can lead to occurrence of Aortic Dissection
- Aortic Aneurysm – A particular part of the Aorta widens or is enlarged because of which this part’s diameter gets bigger than the remaining Aorta. The enlarged portion becomes weak
- Aortic Dissection – This is the result of an Aortic Aneurysm that is there for a long time. It happens when the dilated section of Aorta is not given timely treatment, it keeps getting weaker. Then it reaches a point, when the inner layer of the Aortic wall tears or separates causing internal bleeding along with other complications
Preparation before this Surgery
There are few things that need to be done or planned before the surgery:
- Discuss with the surgeon about the medications that you take on a regular basis. For example, if the patient takes medicine for Diabetes, then these medicines much be stopped at least there days before the surgery
- It is important that the patient’s bowel is clear
- The patient must not eat or drink anything past midnight before the day of the surgery
Diagnostic Tests done for a Bentall Surgery
Similar to any surgery or treatment, there is an evaluation phase that is done before this surgery as well. Mostly, the tests that are suggested, include:
- Detailed imaging tests, such as Trans-oesophageal Echocardiogram
- Computed Tomography Angiogram and
- Magnetic Resonance Imaging Angiogram to find out the presence of Aortic Aneurysms
These are the latest imaging tests that help in finding out the tears in the inner layer of the Aortic wall, a condition known as Aortic Dissection and thus, the right course of treatment can be finalized. Other than these tests, a thorough evaluation of the patient’s family history, medical history to find out the root cause of the ailment, is also done.
How is Bentall Surgery done?
The Bentall Surgery is also referred to as Aortic Root Replacement. The Aortic Root is the portion of the Aorta, which is attached to the Heart. The Aortic Root includes the leaflets of the Aortic Valve, the Annulus, a tough, fibrous ring and the openings where the Coronary Arteries attach, which is the Coronary Ostia.
The surgery is performed in the following manner:
- The whole surgery takes about 4-5 hours to finish
- The surgery requires general anaesthesia
- An incision is made at the middle of Chest to access the Heart – the Sternum is divided
- The Heart’s activity is stopped for sometime for smooth implementation of the procedure; this is done by connecting the patient to a Heart-Lung Bypass Machine
- The defective part of the Aorta is removed, the faulty valves are removed too
- Then the Coronary Arteries and the surrounding walls of the Aorta too are dissected
- A synthetic graft having a bio-prosthetic valve is stitched to the edges of the Aorta
- Then, two openings are made in this artificial graft to which the Coronary Artery is fitted
- If there is any valve leakage, thenit is replaced
- Once all the replacements are done, the incision is stitched
- The patient is taken off the Heart-Lung Bypass machine
There is Valve-sparing Aortic Root Repair in which the surgeon replaces the enlarged portion of the Aorta with an artificial tube or graft. The Aortic Valve remains in its position.
Not everyone is an apt candidate for the minimally invasive approach of this surgery but surely there is a minimally invasive approach possible, which is known as a Mini-Bentall Surgery. In this, a smaller cut in required, and only the top half of the Sternum is divided.
Benefits of the Bentall Procedure
- Long term relief from the issues of the Aorta
- Patients get freedom from the requirement for anti-coagulation
- Being a modern surgery, the precision level is very high
- Mini-Bentall Surgery
- Smaller incisions
- Better cosmetic outcome
- Loss of blood is less
- Lowered risk of infection
- Less pain and trauma after the surgery
- Shorter hospital stays– generally 3-4 days
- Faster recovery
- Patient can get back to usual regimen faster
Recovery after Bentall Surgery
- The nursing staff will help during dressing the incision site
- It takes about 6-8 weeks for the breastbone to heal and so the patient has to be very careful about this. The surgeon and the nursing staff will guide the patient to move his or her body safely and carefully
- Constipation is normal after any surgery – can happen due to the medication or because of the dietary changes or because the patient is less active. For this, there are medications given, also diet that includes fruits, vegetables, fluids, etc. can help
- The patient might help tightness around the chest and shoulders, which is normal. For this, medications are given so that the patient can sleep comfortably
- The patient might also face palpitations. This is because the Heart is sensitive after the surgery, but it settles down in about four weeks and medications are prescribed too
- Stitches and wires will be removed before the patient is discharged
- Increase the physical activity slowly and progressively as possible and can be tolerated by the body
- Also, the patient’s appetite goes down, which can take about three months to get back to normal
- The patient’s is taught breathing exercises and coughing techniques, which won’thamper the recovery process
What are the risks of a Bentall procedure?
As might happen with any procedure, there are a few complications associated with the Bentall surgery. There are very rare and even if occur, these are temporary. Some of the common risks, which not more than 5 percent of patients may come across, include:
- Abnormal Heart rhythms that are known as Arrhythmias– mostly temporary
- Short term memory problems
- Blurred vision
- Difficulty in concentrating
There are some uncommon risks too, which less than 5 percent of patients face. These include:
- Lung infection or Pneumonia
- Septic shock – serious infection and inflammation
- Kidney problems
- Liver failure
- Heart Attack or stroke
- Blood clot in Lung or legs
- Can have a fatal outcome too
The surgeon and patient must have pre-surgery discussion so that the patient and his or her family is taking an informed decision. There is no doubt that these above mentioned risks are there, but at the same time, the advantages of this surgery definitely make it worth.
Life after Bentall Surgery
The rehabilitation period is extremely crucial for Heart patients. Having undergone a surgery, there are many aspects of this phase that the patients need to be careful about:
- Avoid any rigorous activity for about 12 weeks after the surgery
- Avoid lifting any kind of heavy objects for the initial few weeks after the surgery
- Do not miss the check up or follow up appointments
- Do not travel till the doctor gives a go ahead
- A well-maintained diet also plays a vital role during this period; the patient must cutdown the Cholesterol rich food
- Low intake of butter, margarine, etc.
- Avoid food containing hydrogenated oils
- Cut down the intake of high fat dairy products such as whole milk, cheese, ice cream
- Eat meat in lesser quantity and increase the intake the fish
- Increase the intake of fibre rich food items such as vegetables, beans, etc.
- Exercise is always beneficial for Heart health. Once the doctor has given a nod, the patient can start with light exercises and do it on regular basis
- Exercises that can prove helpful for Heart and Lungs – this will enhance the way Heart and Lungs use oxygen
- However, the patient must be wary about avoiding over exertion
It is very important that the patients are aware of the signs or symptoms, or any kind of uneasiness for that matter, when they need to make the earliest possible appointment with their surgeon. Some of these symptoms that the patients need to be wary about:
- High fever
- Redness at the site of the incision
- Drainage from the incision site
- Incisional tenderness
Why India is the best venue for getting a Bentall Procedure done?
The pace at which India has progressed is highly commendable; especially, the field of healthcare has undeniably evolved in leaps and bounds, which is why India has emerged to be a very favoured choice as the treatment venue for many, including enumerable international patients. Further, with the advent of ‘Medical Tourism’, patients from all over the globe are able to avail treatment without any hassles. One of the key reasons are the hospitals in India that are setting milestones after milestones with every passing year. With the right kind of infrastructure, very safe and hygienic ambience, extremely trained nurses, and cost effective cure, the hospitals are undeniably making the visit totally worth for the patients. These hospitals have each and every treatment aspect covered to meet the expectations of the patients.
Some of the world renowned hospitals, where this surgery is performed with very high success rates, are:
- Sakra World Hospital
- Max Super Specialty Hospital, Delhi
- Indraprastha Apollo Hospitals, Delhi
- Medanta – the Medicity, Gurgaon
- Fortis Memorial Research Institute, Gurgaon
- Fortis Escorts
- Desun Hospital, Kolkata
- Paras Hospitals
- Artemis Hospital, Gurgaon
- BLK Super Specialty Hospital, Delhi
- Narayana Institute of Cardiac Sciences, Bengaluru
- Narayana Super Specialty Hospital, Gurgaon
- SevenHills Hospital, Mumbai
- Apollo Hospital, Chennai
- Global Hospital, Chennai
Furthermore, Bentall procedure is known to be a highly complex and high risk procedure, so it is obvious that it needs utmost surgical proficiency to bring maximum results. In this matter, India is definitely ahead than many other countries as there are enormously talented surgeons, who have handled many cases, where a Bendall Surgery was required. These surgeons have thorough experience, ensure that the patients face minimum discomfort and receive supreme care. This ascertains fast recovery and the patients are guided aptly during their rehabilitation period by these Cardiac experts. The Indian Cardiac surgeons have pioneered many treatment techniques and have raised the bar with passing time. Not only by Indian patients, but these reputed Cardiac cure specialists are highly preferred by overseas patients too. Some of these esteemed names are:
- Dr. Anil Bhan
- Dr. Manjinder Singh Sandhu
- Dr. Veenu Kaul
- Dr. Kartikeya Bhargava
- Dr. Rishi Vinod Lohiya
- Dr. Manish Bansal
- Dr. Murtaza A. Chisti
- Dr. Naresh Trehan
- Dr. Subhash Kumar Sinha
Thus, with the perfect features for undergoing any treatment successfully – state-of-the-art hospitals, highly learned Cardiac surgeons, very cost effective facilities, aptly trained nursing staff and much more – which make India a rewarding treatment venue in every way. So, if you have been recommended to undergo a Bentall Surgery, and if you are still looking for a suitable venue, then India can be perfect for you. Also, if you have finalized India as the final destination for Bentall Surgery, then your experience would be more rewarding if you choose to avail the assistance of India Cardiac Surgery Site.
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