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Updated: Jun 19, 2025
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Aortic Root Remodeling in the Tricuspid Aortic Valve
Isabelle Claus1, Christian Giebels2, Tristan Ehrlich2
1Department Cardiac Surgery, Ghent University Hospital, Ghent, Belgium.
The Annals of Thoracic Surgery
|July 25, 2024
Summary
Aortic root remodeling can achieve excellent valve durability when quantitative intraoperative measurements of valve configuration are used. This valve-preserving surgery is a valid option for aortic root replacement, with good long-term results.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Aortic Root Surgery
Background:
- Aortic root remodeling is a key valve-preserving technique for root replacement.
- Its effectiveness and long-term durability have been debated.
- This review examines factors influencing success and failure in aortic root remodeling.
Purpose of the Study:
- To review existing literature on aortic root remodeling.
- To identify factors contributing to both successful outcomes and failures.
- To assess the durability of the aortic valve after root remodeling.
Main Methods:
- Systematic review of publications on root remodeling for aortic aneurysm or dissection.
- Inclusion criteria: tricuspid aortic valves and >15 patients per study.
- Focus on preoperative and intraoperative management details.
Main Results:
- Heterogeneous patient series with a mean age of 52; 22% had connective tissue disease.
- 5-year survival ranged from 58% to 100%; most series lacked annuloplasty.
- Quantitative assessment of valve configuration, especially effective height, improved outcomes and cusp prolapse correction.
Conclusions:
- Excellent valve durability is achievable with quantitative intraoperative assessment during root remodeling.
- Annuloplasty may enhance aortic valve competence, though its impact on durability requires further study.
- Root remodeling is a valid valve-preserving root replacement with good long-term results, extending into the second postoperative decade.
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