Selective Sinus Replacement for Aortic Root Aneurysm: Durable Approach in Selected Patients.

Area of Science:

• Cardiovascular Surgery
• Aortic Surgery
• Aortic Root Aneurysm Repair

Background:

• Selective sinus replacement (SSR) is a tailored surgical approach for sinus of Valsalva or asymmetric aortic root aneurysms.
• This technique avoids coronary reimplantation for healthy sinuses, potentially reducing operative time.

Purpose of the Study:

• To describe patient selection criteria for SSR.
• To assess operative outcomes and late aortic root dimensions following SSR.

Main Methods:

• A retrospective review of 60 patients who underwent SSR between 2006 and 2020.
• Mixed-effects models analyzed postoperative growth of remaining sinuses, adjusting for patient age, valve morphology, and baseline root diameter.

Main Results:

• No operative mortality or major complications (stroke, renal/respiratory failure) were observed.
• Median aortic root diameter decreased significantly post-surgery (53 mm to 42 mm).
• Midterm root growth averaged 0.2 mm/year with no late reinterventions.

Conclusions:

• SSR is associated with excellent operative outcomes and durable midterm results for aortic root aneurysms.
• The technique appears safe and effective, though longer-term follow-up is necessary to confirm sustained aortic root stability.