CT scan as a tool to evaluate root reconstruction and aortic valve repair

Cardiac computed tomography (CT) is an important tool in the management of patients with aortic root and ascending aorta dilatation. It complements echocardiography by providing high-resolution, three-dimensional images that enhance the assessment of aortic anatomy and help to determine the optimal timing for surgical intervention. Beyond preoperative planning, CT also plays an important role in postoperative surveillance by enabling early detection of changes or complications. Accurate imaging is essential for successful surgical outcomes, particularly given the complex structure of the aortic root and its relationship with the base of the left ventricle. Advances in CT technology, including improvements in spatial and temporal resolution, now allow surgeons to obtain highly detailed, accurate images of the aortic root, which are critical for planning aortic valve-sparing procedures. These detailed images provide a clearer picture of the root’s anatomy and structural components, thereby supporting more informed and precise surgical decision making. Intraoperative decision making based solely on surgical experience may always yield optimal results. This is because the aortic root is not under physiological stress during surgery, and outcomes may vary depending on the surgeon’s level of experience. These factors can influence the success of the procedure. This review highlights the growing importance of cardiac CT in the preoperative planning of complex aortic root surgeries. By providing clear, detailed anatomical data, CT enables surgeons to develop more individualized surgical strategies, ultimately improving outcomes and supporting personalized care for patients with aortic root aneurysms.