First Bentall Procedure in Dr. Mohammad Hoesin Hospital: A case report
Main Article Content
Keywords
Antiarrhythmic drug therapy, Bentall procedure, chest tube insertion, pleural effusions, postoperative atrial fibrillation
Abstract
Introduction: The Bentall procedure is a complex surgical intervention to correct aortic root abnormalities, often associated with ascending aortic and aortic valve dysfunction. Despite advancements in improving patient outcomes, postoperative complications such as atrial fibrillation (POAF) and pleural effusions can still occur. This case report illustrates the successful management of these complications following the Bentall procedure.
Case: A 61-year-old woman with untreated severe aortic regurgitation and an aortic root measuring 5.8 cm underwent a Bentall procedure. The surgery involved aortic and right atrial cannulation, preservation of coronary buttons, aortic valve replacement with a size 21 mechanical valve via the supra-annular technique, ascending aorta replacement with a polytetrafluoroethylene (PTFE) graft, and coronary reimplantation. Postoperatively, she developed atrial fibrillation with rapid ventricular response (AF-RVR) and bilateral pleural effusions. AF-RVR was effectively managed with bisoprolol and digoxin, restoring sinus rhythm. Pleural effusions were successfully drained via chest tube insertion, relieving symptoms. These complications were likely due to surgical trauma and systemic inflammatory response, exacerbated by her age and hypertension. This case underscores the potential for postoperative complications after the Bentall procedure and highlights the importance of effective management strategies.
Conclusion: This case demonstrates successful management of postoperative atrial fibrillation and pleural effusions following a Bentall procedure. The favorable outcome underscores the importance of vigilant postoperative monitoring and a multidisciplinary approach in optimizing care after complex cardiac surgery.
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