Reimplantation valve-sparing aortic root replacement is the most durable approach to facilitate aortic valve repair

Reimplantation of the aortic valve has been performed for 3 decades, and experience shows that patient selection and meticulous operative technique are crucial to provide excellent clinical outcomes and stable aortic valve function for decades. More than the type of the Dacron graft used for the reimplantation (straight graft or Valsalva graft), we believe that attention to certain technical aspects of this operation is key to a successful and durable aortic valve reconstruction. This article describes the operative procedure as we believe it should be performed based on a learned experience with several hundred cases and summarizes the latest outcomes in a large cohort of patients followed prospectively during the past 3 decades.