Bentall Surgery In India
Our heart's aorta is the largest artery that stems from the heart and branches into smaller arteries to dispense oxygenated blood to all parts of the body. It can be segmented into:
- part that rises from the heart - the ascending aorta
- part that bends over the heart - aortic arch
- part that moves down the chest region - descending thoracic aorta
- part that begins at the diaphragm - abdominal aorta.
The Bentall procedure is a surgery that is performed to rectify defects of the aorta. The procedure includes the replacement of the aortic root (base of the aorta) and valve (three flaps that ensure the one-way flow of blood from the heart to the aorta), and reimplanting of the coronary arteries (that branch out from the ascending aorta). The most recent type of surgery is known as the button Bentall surgery.
The Bentall surgery is advised for the following conditions of the aorta:
- Leaking of the aortic valve - Aortic Regurgitation
- Genetic disease that leads to aortic wall weakness - Marfan's syndrome
- Separation of the aortic wall layers- Aortic dissection
- Extended Growth of the aorta - Aortic aneurysm
The surgery may also have to be performed in cases of aneurysms, where the
ascending aorta balloons out. The surgery helps in preventing the aorta from rupturing and causing a fatal hemorrhage.
The Bentall surgery is carried out under general anaesthesia.
During the surgery, an incision is made along the middle of the chest to access the heart. The heart's activity is temporarily stopped by surgeon to perform the operation, and blood flow is redirected to a heart lung machine.
The diseased part of patient's aorta is removed and the valve is examined. The diseased aortic valves are then removed. The coronary arteries, along with a large portion of the surrounding wall of the aorta are also dissected. An artificial graft that has a mechanical or bioprosthetic valve is sutured at the ends of the aorta. Two holes are created in the graft, and the coronary artery buttons are sewn into it. The valve replacement may be evaluated by the cardiac surgeon by streaming some blood into the area and inspecting for any kind of leakage. Once the repair is done completely, the incision is closed.
After the surgery, patient is shifted to the post anaesthesia care unit and put on a ventilator where his/her vitals are monitored. Before discharge, the treating doctor gives a set of instructions to be followed such as:
- Increasing physical activity progressively as tolerable.
- Avoiding any vigorous activity/exertion for up to 12 weeks after the surgery.
- Also do not lift any sort of heavy weights for the first few weeks after the surgery.
How to Keep the Heart Healthy After Surgery
Some basic lifestyle changes would be required to keep the heart healthy after surgery. The two most important ways to stay healthy are -
- Like any other muscle of our body, heart too works best with routine exercise. Staying active
helps in reducing stress, lowering cholesterol level, and losing weight. But the kind and
frequency of exercise should first be discussed with the healthcare provider. He or she would
suggest a cardiac rehabilitation program that is very useful for patients after surgery.
- Exercise that involves working out for lungs and heart can improve the way they use oxygen.
So, choose an activity accordingly.
- The entire exercise need not be done in one go. One needs to start slowly and then build it up
over a period of time.
- Over exertion should be avoided.
Eating Heart-Healthy Food
Eating habits can help in lowering down cholesterol, blood pressure, and weight. One thing to keep in mind here is that food need not be tasteless and boring to be healthy. Following tips can be helpful:
Consumption of Less Fat
- Eat smaller number of fatty cuts of meat and increase intake of fish.
- Reduce the use of butter, margarine, and lard.
- Keep away from foods containing hydrogenated oils.
- Eat lesser high-fat dairy products such as cheese, whole milk and ice cream.
Consumption of Less Salt
- Do not mix additional salt to food after cooking, and keep the salt shaker off the dining table.
- Do not use sauces or cooking aids that have high salt content such as baking powder, baking
soda and soya sauce.
- In place of salt, food can be seasoned with herbs and flavoring agents like onion, garlic and
Consumption of More Fiber
- Augment the consumption of fresh vegetables and fruits.
- Include oats, whole-grain rice, and bran to the diet.
- Eat more beans and vegetables that are good sources of fiber.
- When eating more fiber, also assure drinking of more water to prevent constipation.
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Cardiothoracic & Vascular Surgery
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MS (General Surgery), MCh (Cardiac Surgery)
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