[Results of Valve Sparing Aortic Root Replacement]

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Valve Repair

Background:

• Aortic root replacement is a critical procedure for patients with aortic root dilation and/or aortic regurgitation.
• Valve sparing aortic root replacement (VSARR) aims to preserve native valve function, potentially improving long-term outcomes.
• Expanding indications for VSARR include patients with significant aortic regurgitation and specific sinus of Valsalva dimensions.

Purpose of the Study:

• To evaluate the efficacy and safety of valve sparing aortic root replacement, primarily using the reimplantation technique.
• To assess early and mid-term outcomes, including operative mortality, aortic regurgitation, survival, and reoperation rates.

Main Methods:

• Ninety-nine patients underwent valve sparing aortic root replacement, with a focus on the reimplantation technique.
• Patient demographics, indications for surgery (including significant aortic regurgitation and sinus Valsalva diameter >40 mm), and valve pathology were recorded.
• Valve plasty techniques included central plication and pericardial patch; outcomes were analyzed retrospectively.

Main Results:

• Operative mortality was low at 1%.
• At discharge, 88% of patients had none or trivial aortic regurgitation.
• Five-year survival was 96%, with a 96% reoperation-free rate, including 5 reoperations and 2 re-repairs.

Conclusions:

• Valve sparing aortic root replacement, particularly the reimplantation technique, is a safe and effective procedure for selected patients.
• The technique achieves excellent functional results with low mortality and high rates of freedom from reoperation.
• VSARR offers a durable solution for aortic root pathology, preserving native valve function and improving long-term patient survival.