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Related Experiment Video

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Durability and survival following valve-sparing root replacement: a longitudinal study.

Siddhant Mehra1,2, Makwana Rohan Kiritkumar1, Devi Prasad Shetty1

  • 1Department of Cardiac Surgery, Narayana Health, Bengaluru, India.

Indian Journal of Thoracic and Cardiovascular Surgery
|April 13, 2026
PubMed
Summary

Valve-sparing root replacement (VSRR) shows excellent survival and low complication rates in patients with dilated aortic roots. This procedure is a viable surgical option for aortic root pathologies.

Keywords:
Aortic root aneurysmConnective tissue disorderDavid procedureValve sparing root replacement

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Dilated aortic roots pose significant risks, including aortic dissection and rupture.
  • Traditional aortic root replacement often necessitates lifelong anticoagulation.
  • Valve-sparing root replacement (VSRR) aims to preserve native aortic valve function.

Purpose of the Study:

  • To evaluate the immediate and long-term outcomes of valve-sparing root replacement (VSRR).
  • To assess survival rates and complication profiles following VSRR in patients with dilated aortic roots.
  • To determine the efficacy of VSRR in managing aortic root pathologies.

Main Methods:

  • An observational study included 91 patients undergoing VSRR from June 2009 to October 2024.
  • Data collected included demographics, pre-operative characteristics, surgical details, and valve morphology.
  • Primary outcome was all-cause mortality; secondary outcomes included valve-related complications and reintervention rates.

Main Results:

  • The cohort (mean age 38.5 years) predominantly had aortic aneurysms (91.2%) and moderate-severe aortic regurgitation (80.2%).
  • 30-day mortality was 3.2%. Mean survival was 12.7 years, with 10-year survival at 86%.
  • Freedom from moderate/severe aortic regurgitation at 5 years was 77%. Surgical complications were low.

Conclusions:

  • VSRR demonstrates excellent long-term survival rates.
  • The procedure is associated with low complication and reintervention rates.
  • VSRR is a viable and effective surgical approach for patients with aortic root pathologies.