title: A safer technique of aortic root replacement after aortic valve replacement.
abstract: Aortic root replacement after aortic valve replacement (AVR) is often complicated by bleeding around the aortic root, which increases the risk of morbidity and mortality, making it a technically challenging procedure. We describe a new technique of aortic root replacement designed to minimize bleeding around the aortic root. This surgical technique focuses on safe dissection and exposure of the aortic root to avoid inadvertent entry into the right atrium or right ventricle; on modifying the proximal anastomosis of the graft to the aortic annulus; and on performing a coronary artery reimplantation that achieves complete hemostasis at the suture lines. We performed aortic root replacement after AVR in four patients over a 4-year period, without encountering any bleeding around the aortic root.
authors.affiliation: Department of Cardiovascular Surgery, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, Fukuoka, 830-8577, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Yoshikai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Keiji
authors.initials: K
authors.lastname: Kamohara
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Fumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Furutachi
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*