A novel technique of aortic root reconstruction for extensive endocarditis: the pericardial skirt technique

Extensive aortic valve endocarditis requires thorough debridement of the paravalvular tissue, and reconstruction of the destroyed aortic root can be technically difficult. In the present report, we describe a simple technique for aortic root reconstruction. In this technique, a doughnut-shaped bovine pericardial sheet (skirt) is attached to the proximal end of a valved conduit and then sewn onto the destroyed aortic annulus. Because skirt flexibility facilitated excellent adaptation to the irregular annular plane, we did not encounter any severe bleeding from the proximal anastomosis of the valved conduit in any of the cases. We believe that our procedure may be beneficial for aortic root reconstruction in patients with extensive endocarditis.