Replacement of the ascending aorta, aortic root, and valve with a novel stentless valved conduit.

Abstract

Biologic valved-conduit grafts avoid the need for anticoagulation and can exploit the excellent hemodynamic performance of stentless valves. Incorporation of sinuses of Valsalva into the neoaortic root can improve the function of the stentless valves. Here we present a novel prefabricated stentless valved conduit incorporating sinuses of Valsalva and describe the technique of implantation. The BioValsalva (Vascutek Terumo, Renfrewshire, Scotland) valved conduit incorporates a stentless porcine aortic valve (Elan; Vascutek Terumo) suspended within a triple-layered vascular conduit (Triplex; Vascutek Terumo) constructed with sinuses of Valsalva. The BioValsalva valved conduit was used in 12 patients with aortic regurgitation due to annuloaortic ectasia unsuitable for aortic valve repair and concomitant ascending aorta aneurysm, with no deaths and excellent functioned result. The prefabricated, composite, stentless valved conduit is composed of material that is hemostatic and reduces bleeding. It is easy to implant, with a short ischemic time, and lends itself well to a variety of insertion techniques.