Key result
Expansile external annuloplasty ring facilitates annular stabilization during the remodelling technique for aortic valve repair.
Case Report (n=2)
This report describes the surgical preparation and technique for annular stabilization in aortic root remodeling for patients with severe aortic insufficiency and root dilation.
Case report of one technique; leaves open durability benefits and should not change practice.
Clinical vignetteCase 1 is a 52-year-old patient with New York Heart Association (NYHA) III dyspnea.Echocardiography demonstrated a tricuspid aortic valve with grade 4 aortic insufficiency (AI), preserved ejection fraction (50%) and a dilated left ventricle with end-diastolic and end-systolic diameters of 63 and 42 mm, respectively.Gated computed tomography (CT) revealed sinuses of Valsalva measuring 57 mm and ascending aorta 44 mm in diameter.Case 2 is a 69-year-old patient with NYHA III dyspnea.Echocardiography demonstrated a bicuspid aortic valve with grade 4 AI, preserved ejection fraction (54%) and a dilated left ventricle with end-diastolic and end-systolic diameters of 59 and 45 mm, respectively.Gated CT revealed sinuses of Valsalva measuring 52 mm and ascending aorta 47 mm in diameter. Surgical techniques PreparationAfter performing a median sternotomy and opening the pericardium, heparinization is undertaken.To maximize the excised ascending aorta length, aorta cannulation is performed high in the arch.Direct antegrade Custodial cardioplegia is used to induce diastolic arrest.
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Danial et al. (2023) conducted a case report in Severe aortic insufficiency with aortic root dilatation (n=2). Annular stabilization in remodelling technique (external annuloplasty) was evaluated. The paper details the surgical steps for performing annular stabilization using an expansile external annuloplasty ring during the remodelling technique for aortic valve repair.
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