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Related Experiment Video

Updated: Jun 22, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

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Published on: December 11, 2017

Valve-sparing aortic root reconstruction using in situ three-dimensional measurements.

Andras C Kollar1, Scott D Lick, Vincent R Conti

  • 1Division of Cardiothoracic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, Texas 77555-0528, USA. ankollar@utmb.edu

The Annals of Thoracic Surgery
|May 26, 2009
PubMed
Summary

Restoring aortic root geometry with a competent valve is a novel surgical approach. This method, using in situ measurements, suggests valve function may not rely on typical root shape.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Root Reconstruction

Background:

  • Aortic root aneurysms alter the native truncated cone geometry, impacting valvular competence.
  • Restoring valve competence early and using 3D measurements may improve aortic root reconstruction predictability.

Purpose of the Study:

  • To evaluate a new surgical approach for aortic root reconstruction.
  • To assess the role of in situ measurements in achieving functional reconstruction.
  • To determine if aortic valve competence depends on normal aortic root geometry.

Main Methods:

  • Downsizing annuloplasty and sinotubular junction plication to achieve valve competence.
  • In situ measurements of basal ring, sinotubular junction, and sinus depth for graft tailoring.
  • Utilizing a novel proximal suture technique combining David subannular fixation and Yacoub remodeling.

Main Results:

  • Ten patients underwent the procedure over 3 years with good postoperative valve function.
  • In situ measurements were performed in 7 patients; 5 showed a reverse cone geometry post-reconstruction.
  • The reverse cone geometry featured a sinotubular junction 2-4 mm larger than the basal ring.

Conclusions:

  • Aortic root rebuilding based on in situ measurements and a competent valve represents a new surgical concept.
  • Postoperative aortic valve competence, even with elongated leaflets, may not necessitate the native truncated cone geometry.
  • This approach offers a predictable method for functional aortic root reconstruction.