Biobental procedure and autologous materials in aortic root surgery

The BioBentall procedure has many options, but the optimal approach is still not determined. Alternative options for aortic root surgery include Ross procedure and modification of the Bentall - De Bono procedure using autologous pericardium leaflets. This literature review showed topical issues of surgical technique and the results of various modifications of the BioBentall operation, as well as methods of the aortic root repair using autologous materials. The search strategy included the analysis of international (PubMed, Scopus, Embase) and Russian's databases (Russian Science Citation Index). The BioBentall procedure demonstrates satisfactory early and long-term results comparable to both the classic Bentall - De Bono procedure and valve-sparing techniques. Composite grafts containing frameless bioprostheses seem to be more promising and durable in comparison with stent-grafts, however, given the minimal amount of publications directly comparing these techniques, further study of this hypothesis is necessary. Total xenopericardial conduits have demonstrated higher rates of degradation and are currently not recommended for use, as demonstrated in most foreign studies. Modified Ross procedure shows excellent hemodynamic outcomes in the long-term follow-up, however, the literature data regarding its applicability in a cohort of patients with proximal aortic aneurysms are limited. The combination of the Bentall - De Bono procedure and autopericardial neocuspidization seems to be a promising and cost-effective method, however, this approach requires a clinical assessment, which results have not been yet published.