The Remadi’s technique or the Bentall Technic? Valsalvas Reduction Plasty

Abstract

The objective of this study was to find an another surgical way than Bentall procedure to treat the aneurysms of ascending aorta involving the sinuses of valsalvas. From September 2008 to May 2018, eighty five patients underwent aortic valve replacement (AVR) associated with a Valsalva plasty, with or without the replacement of the ascending aorta. All the procedures were performed by a single surgeon (Remadi’s technique) at Amiens Universitary Hospital in France. There was no operative death. During the follow-up at ten years, the diameters of the Sinuses of Valsalva remain steady, without long term post-operative aneurysm or reoperation for any aortic complication. This original new technic, can be applied safety for almost all ascending aorta aneurysms involving valsalvas (more than 90% of cases) instead of the bentall procedure. This new technic is safe with excellent immediate and mid- term results. The Remadi’s technic is particularly adapted for the older patients or patients with associated comorbidity in order to reduce the operative risk. The Bentall’technic should be performed only when the ascending aorta has a shape like a « chianti bottle with very important dilatation of sinuses of valsalvas, when its the only procedure adapted for those remaining indications.