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Valve-Sparing Aortic Root Surgery

Maral Ouzounian, MD, PhD, Tirone David, MD
Valve-Sparing Aortic Root Surgery is a topic covered in the Adult and Pediatric Cardiac.

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Abstract

Aortic valve-sparing (AVS) operations were developed to treat aortic root aneurysms while preserving the native aortic valve and have become established alternatives to composite valve graft procedures for patients with favorable cusp morphology. The theoretical benefits of AVS procedures include avoiding the complications associated with prosthetic valves, specifically, the risks of systemic thromboembolism and lifelong anticoagulation associated with mechanical valves, or the risks of structural valve deterioration and need for reoperation associated with bioprosthetic valves.

Although valve-sparing root replacement techniques have been available for more than 30 years,[1],[2] the proportion of AVS operations among patients undergoing root replacement in the United States has remained at approximately 15% and is not increasing.[3] Reluctance to perform AVS may be due in part to concerns regarding the durability of these procedures and the lack of comparative data regarding the long-term safety and effectiveness of AVS compared with traditional Bentall procedures.

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Abstract

Aortic valve-sparing (AVS) operations were developed to treat aortic root aneurysms while preserving the native aortic valve and have become established alternatives to composite valve graft procedures for patients with favorable cusp morphology. The theoretical benefits of AVS procedures include avoiding the complications associated with prosthetic valves, specifically, the risks of systemic thromboembolism and lifelong anticoagulation associated with mechanical valves, or the risks of structural valve deterioration and need for reoperation associated with bioprosthetic valves.

Although valve-sparing root replacement techniques have been available for more than 30 years,[1],[2] the proportion of AVS operations among patients undergoing root replacement in the United States has remained at approximately 15% and is not increasing.[3] Reluctance to perform AVS may be due in part to concerns regarding the durability of these procedures and the lack of comparative data regarding the long-term safety and effectiveness of AVS compared with traditional Bentall procedures.

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Last updated: October 9, 2020