Personalized External Aortic Root Support (PEARS) for Neoaortic Valve Insufficiency After Arterial Switch Operation

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•A comprehensive overview of a novel management option for aortic root aneurysms in patients with neoaortic root dilatation following the arterial switch operation: Personalized External Aortic Root Support (PEARS) •Includes a description of the key principles of patient selection, surgical steps and postoperative care •Detailed figures describing the implantation of a PEARS device with attention to the unusual anatomy encountered in the post-ASO patient The PEARS procedure offers a novel alternative to traditional surgical options for aortic root aneurysms in patients with neoaortic root dilatation following the arterial switch operation. The patient's own aortic valve, root architecture and blood to vessel wall interface are preserved. Avoiding a mechanical prosthesis negates the requirement for anticoagulation which is especially beneficial in young patients. This article aims to describe the key principles and operative steps for implanting the PEARS device around the dilated neoaortic root after the arterial switch operation. The PEARS procedure offers a novel alternative to traditional surgical options for aortic root aneurysms in patients with neoaortic root dilatation following the arterial switch operation. The patient's own aortic valve, root architecture and blood to vessel wall interface are preserved. Avoiding a mechanical prosthesis negates the requirement for anticoagulation which is especially beneficial in young patients. This article aims to describe the key principles and operative steps for implanting the PEARS device around the dilated neoaortic root after the arterial switch operation. Commentary: PEARS – Good Fruit for the Congenital Heart Surgeon?Operative Techniques in Thoracic and Cardiovascular SurgeryVol. 26Issue 2PreviewRobicsek et al. introduced the concept of aortic wrapping in 1971 using synthetic vascular grafts.1 In 2014, Treasure reported their first cohort of 30 patients with connective tissue disease and the use of a personalized external aortic root support (PEARS).2 Unlike vascular grafts, PEARS is personalized to each patient's anatomy and has interstices that provide flexibility and importantly prevent entrapment of fluid between the graft and the aortic wall. Kenny et al. in the current report describe PEARS to stabilize the post arterial switch (ASO) aneurysmal neo-aortic root. Full-Text PDF