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Updated: Jan 26, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.6K

Valve-sparing aortic root replacement in children: Outcomes from 100 consecutive cases

Charles D Fraser1, Rui Han Liu1, Xun Zhou1

  • 1Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, Md.

The Journal of Thoracic and Cardiovascular Surgery
|April 16, 2019
PubMed

Insights

Valve-sparing root replacement is a safe and effective option for pediatric aortic root aneurysms. The reimplantation technique is preferred, though late aortic insufficiency and pseudoaneurysms require monitoring.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Aortic Disease

Background:

  • Aortic root aneurysms in children often necessitate surgical intervention.
  • Valve-sparing root replacement (VSRR) offers an alternative to traditional prostheses.
  • Limited data exist on long-term outcomes of VSRR in pediatric populations.

Purpose of the Study:

  • To evaluate the safety and efficacy of VSRR in pediatric patients.
  • To compare outcomes between different VSRR techniques.
  • To identify risk factors for complications and reinterventions.

Main Methods:

  • Retrospective review of 100 consecutive pediatric VSRR procedures from 1997-2017.
  • Analysis of echocardiographic and clinical data.
  • Primary endpoint: mortality; Secondary endpoints: complications, reinterventions, valvular dysfunction.

Main Results:

  • Median age was 13.6 years; common diagnoses included Marfan and Loeys-Dietz syndromes.
  • Perioperative mortality was 2%. Late reinterventions were needed for pseudoaneurysms in 6% of patients.
  • Reimplantation procedures showed significantly lower rates of late valve replacement compared to remodeling (5.9% vs. 33.3%).

Conclusions:

  • VSRR is a safe and effective treatment for pediatric aortic root aneurysms.
  • The reimplantation technique is associated with better long-term valve outcomes.
  • Late aortic insufficiency and pseudoaneurysm formation are potential complications requiring vigilance.
Abstract

Keywords:
Loeys–Dietz syndromeMarfan syndromepediatricsvalve-sparing aortic root replacement

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