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Bentall’s Procedure

Bentall’s Procedure is a major open-heart surgery performed to treat serious diseases of the aortic root and the aortic valve. These conditions may be caused by an aneurysm (ballooning of aorta), dissection (partial tear of aorta), or severe valve disease.

In this procedure, the surgeon replaces:

  • The aortic valve
  • The aortic root
  • The ascending aorta

—all together—using a special tube-like graft that already contains a valve (called a composite graft).
The coronary arteries, which supply blood to the heart muscle, are then carefully reattached to this new graft.

This operation restores normal blood flow, prevents life-threatening complications, and is one of the most effective and durable treatments for complex aortic diseases.

Why Is Bentall’s Procedure Done?

Bentall’s Procedure is recommended when there is significant disease affecting both the aorta and the aortic valve, such as:
  1. Aortic Root Aneurysm
    A dangerous enlargement or ballooning of the aortic root.
  1. Aortic Dissection
    A tear in the inner layer of the aorta.
  1. Severe Aortic Valve Disease
    Either narrowing (aortic stenosis) or leakage (aortic regurgitation).
  1. Connective Tissue Disorders
    Conditions such as Marfan Syndrome or Ehlers-Danlos Syndrome, which weaken the aortic wall.
  1. Bicuspid Aortic Valve with Root Dilatation
    A congenital condition where both the valve and aorta gradually weaken. If not treated in time, these conditions may lead to:
    • Heart failure
    • Aortic rupture
    • Sudden cardiac death
      • Bentall’s surgery prevents these complications.

How Is Bentall’s Procedure Performed?

The surgery is done under general anesthesia and typically takes 4–6 hours.

Step 1 — Anesthesia & Heart-Lung Machine

You are put to sleep, and the heart-lung machine temporarily takes over blood circulation.

Step 2 — Exposing the Aorta

The surgeon opens the chest to access the aortic root and aortic valve.

Step 3 — Removing the Diseased Section

The damaged aortic valve, aortic root, and ascending aorta are carefully removed.

Step 4 — Implanting the Composite Graft

A graft tube with an attached mechanical or biological valve is placed and stitched into position.

Step 5 — Reattaching Coronary Arteries

The coronary arteries are reimplanted into the graft so that the heart continues to receive blood.

Step 6 — Restoring Circulation & Closure

Once the repair is complete, normal blood flow is restored, and the chest is closed.

What are the types of Grafts Used?

  1. Mechanical Valve Composite Graft

    • It has metallic valves attached to it.

    • Lasts lifelong

    • Requires lifelong blood-thinning medication

  1. Biological (Tissue) Valve Composite Graft

    • It is made from animal tissue

    • Does not require lifelong blood thinners

    • May need replacement in 10–15 years

    Your surgeon will choose the best graft depending on age, lifestyle, medical condition, and future pregnancy plans.

What are the Benefits of Bentall’s Procedure

  • It treats both the aorta and aortic valve in a single operation

  • It prevents aortic rupture or dissection

  • It restores normal heart function and blood flow

  • It has excellent long-term results

  • It improves life expectancy and quality of life in patients with serious aortic disease

How does Recovery take place After Bentall’s Procedure?

Recovery takes place in stages:
  1. ICU Stay (1–2 days)
    2. Continuous monitoring of heart function, blood pressure, and healing.
  1. Hospital Stay (7–10 days)
    2. Gradual mobilization, medication adjustment, breathing exercises.
  1. Full Recovery (6–8 weeks)
    2. Depends on age, overall health, and surgical complexity.
Post-operative care includes:
  • Blood-thinning medicines (if mechanical valve)
  • Regular echocardiograms to check graft and valve function
  • Lifestyle changes such as a heart-healthy diet and mild exercise
  • Cardiac rehabilitation for strength and stamina
  • Avoiding heavy lifting for several weeks

What are the Possible Risks and Complications of Bentall Procedure?

Bentall’s Procedure is complex, but very safe in experienced hands.
Possible risks include:

  • Bleeding or infection

  • Irregular heart rhythms

  • Stroke or clot formation

  • Leakage at the graft connection (rare)

  • Complications related to blood-thinners

Choosing an experienced cardiac surgery team greatly reduces risks.

Dr. Svati Bansal
Dr. Vikas Kumar Keshri

MBBS, MS, MCh, FRCS-CTh,
FRCS-CTh(Ed), MEBCTS, FEBCTS, FACS(USA), DNB, MNAMS, MBA

Associate Director
Cardio-thoracic and Vascular Surgery
Yashoda Medicity, Ghaziabad(UP)

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Frequently Asked Questions

What exactly is Bentall’s Procedure?

See above.

In many patients, both the valve and the aorta are diseased. Treating only one part would leave the other dangerously weak. Bentall’s Procedure treats the whole diseased segment in one step, giving the safest and most durable result.

Yes. It is a major open-heart surgery. However, in modern centers, success rates are excellent, and most patients recover well.

  • Mechanical graft: Lifelong

  • Biological graft: Usually 10–15 years

    Your surgeon will recommend what’s best based on age and lifestyle.

Yes, lifelong if you receive a mechanical valve.
No lifelong blood thinners are needed if you get a biological valve, though short-term medication may still be required.

Most patients return to daily activities within 6–8 weeks.
Heavier physical activity may take longer and should be guided by your doctor.

Seek immediate care if you notice:

  • Breathlessness

  • Fever

  • Irregular heartbeat

  • Sudden chest or back pain

  • Dizziness or fainting

  • Excessive bleeding or bruising

Yes.
Most patients lead full, active, and normal lives after surgery, provided they:

  • Control blood pressure

  • Take prescribed medicines

  • Attend regular check-ups

  • Maintain a healthy lifestyle

In some cases—especially if you have Marfan syndrome, Ehlers-Danlos syndrome, bicuspid aortic valve, or a family history of aortic aneurysm—your close relatives should be screened.
Your doctor will advise which family members need testing.

No surgery can be “prevented,” but the disease leading to surgery can often be slowed by controlling blood pressure, avoiding smoking, treating cholesterol, and regular monitoring if you have known aortic disease.

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