Summary
Valve-sparing operations for aortic root aneurysms are increasing in frequency, but techniques and results are still under evaluation. The aortic root is a dynamic unit that performs very sophisticated cyclic movements. Its dynamic characteristics are aimed at reducing stress on the cusps, and optimizing ventricular-arterial coupling to warrant hemodynamic efficiency without structural deterioration of the cusps over time. A better understanding of aortic valve function has led to appreciation of the role of adjacent structures in modulating leaflet movements. A very important step in this direction was the recognition of the role of the sinuses of Valsalva in smooth leaflet approximation. The reimplantation type of valve sparing procedure using the new Valsalva graft that incorporates the neo-sinuses, combines the advantages of proper anatomical reconstruction typical of the original remodeling technique with those of annular stabilization proper of the original reimplantation technique. The surgical approach and the various steps can be standardized and overall results are reproducible. Whether these improvements will translate in extending the long-term durability of the aortic leaflets remain to be determined.
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Paulis, R.D., Scaffa, R., Maselli, D., Bellisario, A., Salica, A. (2009). What's New in Aortic Root Reimplantation?. In: Kazui, T., Takamoto, S. (eds) Advances in Understanding Aortic Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-99237-0_27
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DOI: https://doi.org/10.1007/978-4-431-99237-0_27
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