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Updated: Mar 30, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
When a Mechanical Valve Goes Freestyle: A Patient Tailored Valve-In-Valve Implantation
J François1, K Cathenis, R Hamerlijnck
1Department of Surgery, AZ Maria Middelares, Ghent, Belgium.
Abstract:
In case of a redo operation after a full root replacement there are two possible options: replacing the entire root or performing a more conservative valve-in-valve implantation. Regarding the relatively high morbidity and mortality of a redo root replacement, the valve-in-valve implantation is the preferred choice if technically feasible. We present the case of a valve-in-valve implantation with a St. Jude mechanical valve in a Medtronic bioprosthesis in a 57-year old man. Follow-up echocardiography after 1 month showed a mean gradient of 17 mmHg and no paravalvular leakage. The combination of a St. Jude bileaflet mechanical valve implanted in a Freestyle root prosthesis has not been described. This case shows that patient tailored treatment with a St. Jude bileaflet mechanical valve in a Freestyle aortic root valve can be safely performed and might be the preferred choice for younger patients, if technically feasible.
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