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Updated: Apr 22, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Modified surgical sequence in aortic and mitral valve replacement with or without tricuspid valve repair or
Antonio Maria Calafiore1, Angela Lorena Iaco2, Aijaz Shah3
1Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia am.calafiore@gmail.com.
Abstract:
A mitral prosthesis, when implanted, can distort the aortic annulus, forcing to downsize the aortic prosthesis. Changing the sequence of tying the sutures (the aortic prosthesis first, then the mitral prosthesis) allows to insert an aortic true-sized prosthesis. In case of associated tricuspid valve surgery, the aortic prosthesis protrudes over the anteroseptal commissure area. The sutures on the tricuspid annulus can be passed before the aortic prosthesis is secured in place.
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