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Updated: Feb 10, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Sutureless Prosthesis Implantation and Ascending Aorta Replacement Through a Ministernotomy Approach
Antonio Lio1, Matteo Ferrarini, Antonio Miceli
1From the Istituto Clinico Sant'Ambrogio, Centro Cardiotoracico, Gruppo Ospedaliero San Donato, Milan, Italy.
Sutureless aortic valve replacement combined with ascending aorta replacement is safe and effective in patients with aneurysms. This technique avoids prosthesis dislodgement and yields good outcomes.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Devices
Background:
- Dilated ascending aorta is common in patients needing aortic valve replacement.
- Ascending aorta aneurysm is a contraindication for sutureless valve implantation due to dislodgement risk.
Purpose of the Study:
- To describe a technique for sutureless prosthesis implantation and concomitant ascending aorta replacement.
- To evaluate the safety and efficacy of this combined procedure.
Main Methods:
- Seven patients underwent aortic valve replacement with a sutureless prosthesis and ascending aorta replacement.
- A J-shaped upper ministernotomy approach was used.
- Graft diameter was selected to maintain a sinotubular junction to aortic annulus ratio < 1.3.
Main Results:
- No in-hospital mortality.
- No paravalvular leakage or prosthesis dislodgement reported.
- Mean cardiopulmonary bypass time: 142 ± 52 min; cross-clamp time: 85 ± 18 min.
Conclusions:
- Sutureless valve implantation with concomitant ascending aorta replacement is safe and reproducible.
- The technique is associated with good postoperative results in selected patients.
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