Abstract
The modified Bentall operation remains the standard for aortic root replacement. Surgical options include a pre-manufactured mechanical aortic root composite graft, a native porcine root, or a biological valve implanted in a tubular or Valsalva graft. Suturing a stented biological valve in the tubular graft is rather easy, but a conventional stentless valve is surgically more demanding and rarely performed. In contrast, implantation of the stentless ATS 3F aortic bioprosthesis (ATS Medical, Minneapolis, MN) in a Valsalva graft is facilitated by the design of the valve with a single inflow suture line and three commissural tabs that have to be sutured to the graft wall only.
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