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Aortic Regurgitation III: Medical Management

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...

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Updated: May 1, 2026

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

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

Published on: December 11, 2017

Valve-sparing aortic root replacement†.

David R Koolbergen¹, Johan S J Manshanden², Berto J Bouma³

¹Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, Netherlands d.r.koolbergen@amc.nl.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|April 19, 2014

Summary

Valve-sparing aortic root replacement shows good outcomes, even with concurrent valve repairs. This procedure is safe for young patients, allowing for successful implantation of adult-sized prostheses.

Keywords:

Aortic valve preservation Aortic valve repair Valve-sparing root replacement

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

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Published on: March 26, 2018

Area of Science:

Cardiovascular Surgery
Cardiac Surgery
Aortic Root Surgery

Background:

Valve-sparing aortic root replacement (VSARR) is a complex procedure.
Concomitant valve repair is often necessary in patients undergoing VSARR.
Understanding long-term outcomes is crucial for patient selection and surgical planning.

Purpose of the Study:

To evaluate the outcomes of valve-sparing aortic root replacement.
To assess the results of associated multiple valve repairs in conjunction with VSARR.
To determine the safety and efficacy of VSARR in a diverse patient population, including young individuals.

Main Methods:

Retrospective review of 97 patients undergoing VSARR between September 2003 and September 2013.
Analysis of patient records and echocardiograms (preoperative, postoperative, and recent).
Detailed documentation of surgical techniques (reimplantation, prosthesis type) and concomitant repairs (aortic valve, mitral valve, tricuspid valve, aortic arch).

Main Results:

Mean follow-up of 4.2 ± 2.4 years with complete follow-up for all patients.
Low incidence of reoperation (1.0%) and aortic valve replacement (4.1%).
Excellent 5-year survival and freedom from mortality, root reoperation, and aortic regurgitation (88.0 ± 0.5%).

Conclusions:

Valve-sparing aortic root replacement yields favorable results, even with a high rate of concomitant valve repair.
The procedure is suitable for very young patients, provided adult-sized prostheses can be implanted.
VSARR offers a safe and effective solution for aortic root pathology with good long-term prospects.