New aortic root remodeling surgery in aortic root aneurysm.

Abstract

We have introduced a new surgical technique for aortic root remodeling in aortic root aneurysm, comprised of aortic annuloplasty, reduction of sinus of Valsalva, and wrapping of the aortic root. At the level of the basal ring, the aortic annulus is fixed with the collar of a Gelweave Valsalva vascular graft (Vascutek, Ltd, Inchinnan, UK). After plication of the dilated sinuses of Valsalva from outside the aorta, the aortic root is wrapped with this prosthesis. The distal end of the graft and the transected aortic wall are sutured together with running sutures. Since September 2006, 10 patients suffering from aortic root aneurysm were successfully operated on using this technique. After a median follow-up of 20.7 months, there were no early deaths and no reoperations due to failure of remodeling surgery. Median diameter of the sinus of Valsalva was reduced from 49.5 mm to 34.0 mm. All patients showed aortic regurgitation of grade 0 or grade 1 at follow-up. Long-term follow-up is necessary to prove the durability of this operation.