A new modified Bentall procedure: the flanged technique.

Replacement of the aortic root with a composite graft containing a prosthetic mechanical valve is the preferred surgical procedure for tailoring the aortic root. A new composite graft is designed with an extension below the prosthetic valve. The flange of the graft is anastomosed to the aortic annulus with a continuous suture. The remainder of the procedure is performed in the usual fashion, with button coronary anastomoses. This method is an alternative to previously described Bentall procedures for all aortic root pathologies, especially in cases with small aortic root precluding root enlargement and in those with defects at the annular and subannular areas that require repair.