Key result
Aortic valve-sparing procedures yield excellent survival and reoperation-free outcomes in experienced centers.
Why the study?
Alterations in any component of the aortic root can lead to aortic regurgitation, requiring an overview of surgical treatment options including valve-sparing operations and total aortic root replacement.
Aortic valve-sparing procedures (such as Yacoub and David techniques) offer excellent survival and freedom from reoperation for selected patients with aortic regurgitation when performed at experienced centers, while the Bentall or Ross procedures remain important alternatives when valve repair is not feasible.
Valve-sparing root surgery informs aortic regurgitation management when feasible; leaves open durability comparisons in prospective cohorts.
This review explores the surgical treatment options for aortic regurgitation. Aortic valve-sparing operations and total aortic root replacement with valved conduits are established standard procedures. Alterations in any component of the aortic root can lead to aortic regurgitation. Today, the primary valve-sparing techniques are remodelling (Yacoub procedure) and reimplantation (David procedure). Severely calcified aortic valves, cusps with retraction or multiple large fenestrations cannot be repaired. In such cases, the en bloc replacement of the aortic valve and the root with different types of composite valve grafts – known as the Bentall procedure – is a feasible option. The procedure in which the diseased aortic valve is replaced with the patient’s own pulmonary valve is known as the Ross procedure. Large-scale studies and meta-analyses confirm that aortic valve-sparing procedures provide excellent survival and freedom from reoperation, making them the best option for selected patients when performed in experienced centres.
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Rajabov et al. (2026) conducted a review in Aortic regurgitation. Aortic valve-sparing operations (Yacoub and David procedures) vs. Total aortic root replacement with valved conduits (Bentall and Ross procedures) was evaluated on Survival and freedom from reoperation. Aortic valve-sparing procedures provide excellent survival and freedom from reoperation for selected patients with aortic regurgitation when performed in experienced centers.
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