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Prosthetic valve sparing aortic root replacement: an improved technique

Vanderbilt Heart and Vascular Institute, Nashville, TN, USA

*Corresponding author. Vanderbilt University Medical Center, Department of Cardiac Surgery, 1215 21st Avenue South, Nashville, TN 37232-8802, USA. Tel.: +1 (615) 343 9195; fax: +1 (615) 343-5248.

E-mail address: john.byrne{at}vanderbilt.edu (J.G. Byrne).

We describe a modified surgical technique to treat patients with a previous history of isolated aortic valve replacement who now require aortic root replacement for an aneurysmal or dissected aorta. This technique consists of replacing the aortic root with a Dacron conduit, leaving intact the previously implanted prosthesis, and re-implanting the coronary arteries in the Dacron graft. Our technique differs from other techniques in that we do not leave behind any aortic tissue remnant and also in that we use a felt strip to obliterate any gap between the old sewing ring and the newly implanted graft. In our opinion, this promotes better hemostasis. We demonstrate that this technique is safe, feasible, and results in acceptable outcomes.

Key Words: Root replacement; Reoperation; Aortic valve prosthesis