Different modalities of aortic root reconstruction with aortic valve-sparing techniques in ascending aortic aneurysms

Abstract

Objectives The aim of the study was to study the different types of valve-sparing aortic root reconstruction techniques to assess the short-term results with respect to improvement of patient's functional status, left ventricular dimensions and functions, and durability of competent aortic valve and to detect predictors of failure of aortic repair. Background The focus on valve-sparing operations and the concomitant re-evaluation of the functional anatomy of the aortic root have demonstrated that aortic root deformation often coexists with architecturally and morphologically normal valve leaflets. Thus, sparing and realigning the leaflets and reconstructing the aortic root have the potential for avoiding prosthetic valve disease. Materials and methods This was a prospective analytical study conducted on 50 consecutive patients with aortic root aneurysm and dissection associated with significant aortic regurgitation. These patients were operated upon using aortic valve reimplantation technique and studied for aortic valve competence. Results Follow-up echocardiography was performed within 30 days postoperative, after 6 months, 1 year, and then yearly. Moderate aortic incompetence was found in four patients (P = 0.001) at 1 year, with 100% freedom from reintervention for valve-related problems. Conclusion Valve-sparing aortic root reimplantation (Tirone-David technique) is effective in correcting aortic insufficiency due to aortic root diseases, with good results with respect to durability of aortic repair.