Key result
Valve-sparing root reimplantation provides excellent long-term freedom from re-intervention across clinical scenarios.
Why the study?
Multiple iterations of valve sparing root replacement with reimplantation technique have been reported, with variations in surgical approach and graft selection.
May support reimplantation in selected aortic root cases; leaves open need for randomized trials to confirm durability.
The first valve sparing root replacement (VSRR) was first described over thirty years ago. Reimplantation is favored at our institution to provide maximum annular support in the setting of annuloaortic ectasia. Multiple iterations for this operation have been reported. Surgical intervention varies in terms of graft sizing, the number and method of inflow suture placement, strategy for annular plication and stabilization, and finally choice of graft type. Our specific technique has evolved over the last eighteen years and the current approach is to use a larger straight graft loosely based on the original Feindel-David formula, six inflow sutures to anchor the graft, and some degree of annular plication with annular stabilization. The long-term results for both trileaflet and bicuspid valves are associated with a low reintervention rate. Herein we provide a clear outline for our specific approach to the reimplantation technique.
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Perri et al. (2023) conducted a review in Aortic root pathology. Valve-sparing root replacement (reimplantation technique) was evaluated. Valve-sparing root replacement via the reimplantation technique is a safe and durable operation that provides excellent long-term freedom from re-intervention across multiple clinical scenarios.
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