Bentall + CABG

1. What is Bentall Procedure + CABG?

The Bentall procedure involves replacement of the diseased aortic root and ascending aorta using a composite graft, typically incorporating an artificial or biological aortic valve when valve replacement is required. The coronary arteries are surgically reimplanted into the graft.

When significant coronary artery blockages are also present, CABG is performed during the same operation to bypass narrowed or blocked coronary arteries.

2. When is it Recommended?

Bentall + CABG may be recommended for selected patients with:

• Aortic root aneurysm
• Ascending aortic aneurysm involving the aortic root
• Severe aortic valve disease with aortic root involvement
• Aortic dissection affecting the aortic root
• Connective-tissue disorders affecting the aorta
• Significant coronary artery disease requiring bypass surgery

The exact surgical approach depends on detailed cardiac and aortic imaging.

3. What Symptoms May a Patient Notice?

Symptoms vary according to the underlying condition and may include:

• Chest pain
• Shortness of breath
• Fatigue
• Palpitations
• Dizziness or fainting
• Reduced exercise tolerance

Aortic aneurysms may sometimes cause no symptoms and be detected during imaging performed for another reason.

4. What Does the Treatment Involve?

The procedure is performed through open-heart surgery, usually using cardiopulmonary bypass.

The general process may include:

Sternotomy → Cardiopulmonary bypass → Removal/reconstruction of diseased aortic root → Composite aortic graft/valve implantation → Coronary artery reimplantation → CABG grafting → Restoration of heart function → ICU monitoring

The exact surgical technique varies according to the patient's anatomy and disease.

5. What Are the Main Treatment Options?

Depending on the underlying condition, treatment options may include:

• Medical monitoring for selected stable aneurysms
• Valve-sparing aortic root replacement in suitable patients
• Bentall procedure
• Ascending aortic replacement
• CABG for coronary artery disease
• Hybrid or other specialised aortic procedures in selected cases

The cardiac surgeon determines the most appropriate approach after reviewing imaging.

6. How Long Does Surgery & Recovery Take?

Bentall + CABG is a major operation and commonly takes approximately 5–8 hours, although the duration can vary significantly.

Typical recovery may include:

• ICU stay: approximately 1–3 days or longer if required
• Hospital stay: approximately 7–14 days
• Initial recovery: several weeks
• Full recovery: often several months

Recovery varies according to age, heart function, complexity of surgery and postoperative progress.

7. What Are the Important Risks or Considerations?

Potential risks include:

• Bleeding
• Infection
• Stroke
• Heart rhythm disturbances
• Heart attack
• Kidney complications
• Respiratory complications
• Blood clots
• Graft or valve-related complications
• Need for prolonged ICU care

The individual surgical risk depends on the patient's overall health and complexity of the heart and aortic disease.

8. Why Consider Treatment in India?

India has specialised cardiac surgery and aortic centres offering:

• Advanced cardiac imaging
• Complex aortic root surgery
• Coronary artery bypass surgery
• Cardiac anaesthesia and perfusion support
• Dedicated cardiac ICUs
• Multidisciplinary cardiac care

9. How Can Medavelle Help?

Medavelle can assist with:

Cardiac report review → Cardiothoracic surgeon coordination → Hospital selection → Treatment planning → Cost estimation → International patient arrangements → Follow-up coordination.

10. What Should the Patient Do Next?

Share cardiac reports → Echocardiography & CT/angiography review → Cardiothoracic surgeon evaluation → Surgical planning → Bentall + CABG → Postoperative recovery.