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Updated: Sep 22, 2025
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Valve-Preserving Root Reimplantation Combined with Arch Procedure: Optimizing Patient Selection
Ahmed A Othman1,2,3, Haytham Elgharably1,2, Patrick R Vargo1,2
1Aorta Center, Heart Vascular and Thoracic Institute, 2569Cleveland Clinic, Cleveland, OH, USA.
Innovations (Philadelphia, Pa.)
|May 23, 2022
Summary
Valve-preserving aortic root reimplantation combined with total aortic arch repair is safe for patients with extensive thoracic aortic disease. This complete repair strategy facilitates future interventions in carefully selected individuals.
Area of Science:
- Cardiovascular Surgery
- Thoracic Aortic Disease Management
- Aortic Reconstruction
Background:
- Thoracic aortic disease often involves multisegment pathology.
- Optimal surgical strategies for complex aortic conditions are continuously evolving.
Purpose of the Study:
- To describe the patient population undergoing valve-preserving aortic root reimplantation (VPARR) and aortic arch repair.
- To analyze outcomes and define patient selection for this combined procedure.
- To compare outcomes of limited versus complete aortic arch repair.
Main Methods:
- Retrospective review of 98 patients from 2008-2018 undergoing VPARR and aortic arch procedures (hemi-arch or total arch with elephant trunk).
- Analysis of indications (aneurysmal disease 61%, dissection 39%) and follow-up data.
- Comparison of reintervention rates between limited and complete repair groups.
Main Results:
- No operative deaths or paraplegia observed.
- Low rates of re-exploration for bleeding and need for aortic valve replacement.
- Complete arch repair group showed higher rates of planned interventions, including endovascular and open thoracoabdominal repair.
Conclusions:
- Single-stage VPARR with total aortic arch replacement is a safe and feasible approach for diffuse aortic pathology.
- Complete proximal aortic repair facilitates subsequent interventions.
- Careful patient selection at specialized centers is crucial for optimal outcomes.
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