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Updated: Sep 12, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Personalized external aortic root support: The Dutch experience.

A M Kougioumtzoglou1, B C Y Lam1, B J Bouma2

  • 1Department of Cardiothoracic Surgery, Heart Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

The Journal of Thoracic and Cardiovascular Surgery
|August 6, 2025
PubMed
Summary
This summary is machine-generated.

The Personalized External Aortic Root Support (PEARS) procedure offers a safe alternative for aortic root aneurysm in connective tissue disease patients, reducing dilation without dissections. This novel stent shows promise for managing aortic root aneurysms, with significant diameter reduction observed post-surgery.

Keywords:
aortic aneurysmconnective tissue diseasepreventive surgery

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Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Engineering
  • Medical Device Innovation

Background:

  • Patients with connective tissue diseases and aortic root aneurysms face risks of dissection and dilation progression.
  • Traditional treatments like total or valve-sparing root replacement have drawbacks including anticoagulation needs and reoperation risks.
  • Personalized External Aortic Root Support (PEARS) is a novel perivascular stent designed to mitigate these risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of the PEARS procedure.
  • To report outcomes in the first 90 patients with connective tissue disease and aortic root aneurysm in the Netherlands.

Main Methods:

  • A total of 90 patients underwent isolated PEARS, Ross-PEARS, or concomitant PEARS procedures between January 2018 and February 2023.
  • Procedures were generally performed off-pump under induced hypotension.
  • Preoperative and postoperative imaging (echocardiography, CT/MRI) and patient characteristics were assessed.

Main Results:

  • Procedural success rate was 96.6% with two conversions to conventional surgery.
  • No deaths, endocarditis, or dissections occurred during follow-up (median 6 months).
  • Significant reduction in aortic root and ascending aortic diameters was observed post-surgery.

Conclusions:

  • The PEARS procedure demonstrates acceptable operative risk and is a viable alternative for aortic root aneurysm treatment.
  • No dissections were noted during follow-up, highlighting a key safety benefit.
  • Potential complications related to coronary artery origin require careful consideration.