Valve-Sparing Aortic Root Replacement

Valve-Sparing Aortic Root Replacement

What is it?

Valve-sparing aortic root replacement is a surgical procedure that repairs abnormal enlargement of the blood vessel walls (aneurysm) within the ascending aorta, which originates in the heart and leads upward to the aortic arch.  The aortic root provides support for the aortic valve leaflets and forms a bridge between the left ventricle and ascending aorta.

People with an ascending aortic aneurysm have a greater risk of aortic dissection, which is caused by a tear in the aorta allowing blood to flow through its inner layer.  This can cause the arterial wall to burst due to the interruption of blood flow and may be life threatening. 

This procedure can be done either as an aortic valve reimplantation, known as the David I technique, or as an aortic valve remodeling procedure, known as the David II or Yacoub procedure. During the procedure, the cardiac surgeon replaces the malformed section of the aorta with an artificial tube (graft). The aortic valve remains in place and the surgeon attaches the valve inside the graft, allowing the patient’s own valve and the new section of the aorta to work together. The procedure is done in an operating room under general anesthesia.

Although it is a newer procedure, early evidence suggests that valve-sparing aortic root replacement can delay or possibly eliminate the need for a subsequent operation that may be necessary with traditional valve replacement surgery.  The procedure has also been shown to reduce the risk of endocarditis or stroke.  It may also be done in patients who have connective tissue disorders, such as Marfan syndrome.

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