Long-term Outcomes After Wrap Versus Open Technique In Bentall Procedures: A Retrospective Cohort Study Of 1,478 Patients

Objective: To evaluate the impact of wrap versus open Bentall procedures on patient survival and long-term clinical outcomes. Methods: We reviewed 1,478 patients who underwent Bentall procedures between 2003 and 2022. Patients were stratified into two groups based on surgical technique: the wrap group (n = 1,274), and the open group (n = 204). Results: The median age was 53 (IQR:43.0–61.0), and 82.9 (%) were male. The wrap group had a higher prevalence of hypertension (39.8% vs. 30.9%; P = 0.019) and a smaller left ventricular end-diastolic diameter (60 mm vs. 65 mm; P < 0.001). there was 4 (0.3%) early deaths in the wrap group and none in the open group. During a median follow-up period of 6.3 (IQR: 3.74–9.44) years, 108 patients died. The 10-year survival was 88.6% (95% CI: 83.1%–94.3%) in the open group and 90.8% (95% CI: 88.8%–93.0%) in the wrap group( P = 0.43). Multivariable Cox proportional hazards analysis showed age, Left Ventricular End Diastolic Diameter Aortic Sinus Diameter, postoperative stroke, and Reoperation were independent predictors of long-term mortality. Surgical technique (wrap vs. open) had no impact on survival. Conclusion: There is no difference in survival following wrapping Bentall versus open Bentall.