DOI: https://doi.org/10.36347/sasjs.2026.v12i01.015

Pages: 88-95

Background: Bentall procedure is a well-established surgical technique for the management of aortic root pathologies with significant aortic regurgitation, particularly in patients with aortic dissection or aneurysm. This study aims to evaluate in-hospital early outcomes and perioperative factors associated with Bentall procedures performed at a single tertiary referral center in Malaysia over an eight-year period. Methods: A retrospective review was conducted on 40 patients who underwent Bentall procedure at Hospital Sultan Idris Shah (HSIS), Selangor, between 2016 and June 2023. Demographic data, operative variables and early postoperative outcomes were analyzed. The primary endpoint was early postoperative mortality. Patients were stratified into two groups: those undergoing isolated Bentall procedures and those undergoing Bentall procedures with concomitant cardiac surgeries. Comparative statistical analyses were performed using SPSS version 28. Results: Major postoperative complications of both groups were sepsis (55.0%), renal failure requiring dialysis (27.5%), and stroke (17.5%). The overall early mortality rate was 32.5%. Mortality was comparable between patients undergoing isolated Bentall procedures (31.8%) and those with concomitant procedures (33.3%) (p=0.919). However, cardiopulmonary bypass (CPB) and aortic cross-clamp times were significantly longer in the concomitant group (p=0.011 and p=0.002 respectively). Survivors had significantly shorter CPB times (mean 350 vs. 452 minutes; p=0.023) and fewer incidences of reoperation for hemodynamic instability (p=0.031). Survivors also had significantly longer CICU and total hospital stays. Conclusion: Despite its complexity, Bentall procedure remains a viable and essential intervention for aortic root disease. Mortality is influenced more by overall patient condition and procedural complexity than by the addition of concomitant surgeries alone. Improved outcomes may be achieved through focused aortic teams,