Valve-Sparing Aortic Root Replacement State-of-the-Art Review, Part I: Anatomy and Physiology.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Aortic valve disease is prevalent, with a preference for valve-preserving techniques.
• Valve-sparing aortic root replacement (VSRR) is increasingly utilized for aortic root pathology in pediatric and adult patients.
• While technically demanding, VSRR offers improving outcomes with experience and modifications.

Purpose of the Study:

• To review the current state of valve-sparing aortic root replacement.
• To focus on patient anatomy and physiology relevant to VSRR candidacy.
• To provide guidance for optimal patient selection in VSRR procedures.

Main Methods:

• Review of current literature and clinical practices regarding VSRR.
• Analysis of anatomical and physiological factors influencing VSRR outcomes.
• Discussion of patient selection criteria based on existing evidence.

Main Results:

• Successful VSRR depends heavily on patient-specific anatomy and pathology.
• Physiological assessment is critical for identifying suitable candidates for valve-sparing procedures.
• Long-term durability is influenced by patient selection, anatomy, and surgical expertise.

Conclusions:

• Careful evaluation of patient anatomy and physiology is paramount for successful VSRR.
• VSRR is a viable and evolving option for managing aortic root disease.
• Optimizing patient selection enhances the likelihood of durable long-term results in VSRR.