Welcome to the forum.
I have consulted with 3-4 professors. One of them suggested the mini Bentall procedure, saying that it involves a smaller incision and my recovery would be faster.
When I spoke with the others, it seems that my entire chest would need to be opened
First of all, good for you for seeking more than one opinion. In my view this is always a good idea.
By mini, I believe you are referring to what would be called a mini-sternotomy. In that your surgeon will be doing a Bentall Procedure, I don't believe that the other minimally invasive procedures, such as the J incision, allow enough access for a Bentall. I could be wrong about that and if someone has had a Bentall with one of the procedures that is even more minimal than the mini-sternotomy, hopefully they will share.
I did, in fact, have a Bentall Procedure and it was with a mini-sternotomy. Getting a Bentall was not the original plan. The plan was to just do a standard aortic valve replacement. In our pre-surgery consults, my surgeon explained that his preferred method is the mini-sternotomy. He has decades of experience as a surgeon and has done thousands of mini-sternotomies. When he explained to me the quicker recovery it sounded good.
As I indicated, the origninal plan was to just replace my aorta, however, when my surgeon got his eyes on my aorta, he determined that it looked as if I had the connective tissue disorder which would lead to me requiring another OHS down the road. So, he opted to shift to a Bentall and replaced my aortic root, as well as my ascending aorta. He did not switch to a full sternotomy when he did this. All of the work was done through the small opening of the mini-sternotomy.
To this day I find his skill set in being able to do all that through only a 3.5 inch opening in my chest remarkable. I think if we lived in a Groundhog Day world and I had 1,000 years to practice, I would never aquire the skills needed to be able to do such a thing. In my consult with my cardiologist after the surgery he shared with me that very few are skilled enough to accomplish this.
One thing thing which I did not think to ask my surgeon in our after surgery consult: If he knew going in that it would be a Bentall, would he still opt for the mini-sternotomy, or would he do a full sternotomy, given the better access the full sternotomy allows.
-If I had to do another OHS and knew beforehand that it would be another Bentall, I would probably lean towards the full sternotomy to give the surgeon better access, to the extent that I had a choice in the matter.
-The benefits of the mini are short term. Yes, the recovery is quicker, but there is no evidence that it leads to any superior long term outcomes.
-There is a reason why the other consults are telling you that you should get the full sternotomy. Better access is an advantage.
-If you feel that the surgeon who is recommending the mini is the one whom you feel the most comfortable with, I guess I would want to have another consult with him and ask more questions. 1) Why does he feel so strongly about doing a mini, given that it will be a Bentall Procesure? 2) How many mini-sternotomies has he done in total? 3) How many times has he completed a Bentall using a mini-sternotomy.
In order for me to feel comfortable, as to his answers to these quesitons: I would want to hear a very good reason why he prefers the mini as it relates to long term outcomes, not just short term recovery. I would want to hear that he's done thousands of mini-sternotomies and at least hundreds of those were Bentall Procedures.
Best of luck with your decision.
