The modified (button) Bentall — replacing the aortic valve and root with a valved conduit, step by step
The case. A 62-year-old with a connective-tissue-type aortopathy is found to have a dilated aortic root and ascending aorta at 5.6 cm, with severe aortic regurgitation and thickened, non-repairable cusps — so a valve-sparing root is not suitable.
Imaging. CT/echo: aneurysmal root effacing the sinuses, eccentric AR jet, dilated LV with preserved function. Coronary ostia patent, arising normally from the right and left sinuses.
The plan. A modified Bentall — aortic root replacement with a bioprosthetic composite valved conduit (a tissue valve inside a Dacron graft), with the coronary arteries reimplanted as buttons. You take the case from skin to closure; tap 📖 Learn at every step for the anatomy, drugs and pitfalls.
🎓 Aimed at healthcare students and practitioners — from first exposure to the operation through to trainee-level detail. Tap 📖 Learn on any step for the core notes, then open the “deep dive” for more depth.
Skill level (affects the precision mini-games)
Disclaimer. This is an educational simulation created for teaching. It deliberately simplifies and stylises a real operation, is not comprehensive, and may contain simplifications or inaccuracies. It is not medical advice and is not a substitute for supervised clinical training, textbooks, or your local protocols and guidelines — it must never be used to guide the care of a real patient. Techniques and sequences vary between surgeons and centres. Non-graphic: no blood or distressing imagery.