Twenty-year follow-up after valve-sparing aortic root replacement with the Yacoub or David procedure in Marfan patients

Figures

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  Figure 1. Echocardiography images for reimplantation (A and B) and remodeling (C and D) technique in Marfan patients. A, Immediate postoperative echocardiographic image after reimplantation technique. B, Echocardiographic image after 20 years following reimplantation technique shows a stable aortic root. C, Immediate postoperative echocardiography image after remodeling technique. D. Echocardiography image after 20 years following remodeling technique shows severe aortic root enlargement (6.2 cm).

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  Video 1. Our remodeling (Yacoub) technique over the past 3 decades. The video describes our suture technique for the prosthetic graft to the aortic remnant during the remodeling technique. Video available at: https://www.jtcvs.org/article/S2666-2736(21)00199-6/fulltext.

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  Figure E1. A, Blue arrows depict the commissures. Black arrows depict severe enlargement of the aortic tissues between the prosthetic graft and the valve insertion/suture line at the non/right commissure. B, Blue arrow depicts the left coronary artery ostium, whereas black arrows show enlargement versus dehiscence between the prosthetic graft suture line and the valve insertion.

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  Figure E2. A, Remodeling technique in patients with Marfan syndrome. The red area depicts the area at high risk for dilation or dehiscence. Orange area depicts annular and subcommissural area at risk for dilatation. A∗, Magnification of commissures depicting the correct suturing technique at the valve insertion. B, Remodeling technique and annuloplasty in Marfan syndrome. Colored area indicates area at risk for dehiscence and dilatation. C, Reimplantation technique in patients with Marfan syndrome.