title: [Our technical modification of aortic valve sparing operation focused on standardization and reproducibility].
abstract: BACKGROUND
  The aortic valve-sparing operation has been accepted as an ideal procedure for the treatment of aortic root aneurysm, especially in young patients. However, this operation is thought to be technically difficult due to lack of conceptual understanding of the procedure for many surgeons. In order to overcome the surgical problem, we have developed a simple valve-sparing aortic root replacement focused on standardization and reproducibility.
  
  
  METHODS
  Seven consecutive patients underwent the aortic valve-sparing operation in our institution.Our surgical strategy to restore valvular competency is based on the concept of inserting a dilated aortic annulus into small sized graft. Regardless of annular diameter, the Valvalva graft of 26 mm was used in all patients. Proximal end of the graft is secured on the outside of the left ventricular outflow tract with 12 mattress sutures. The 3 commissures are suspended upward inside the graft as possible. The remnants of aortic sinuses are sutured to the graft in U-shaped manner using continuous suture line. If necessary, aortic cusp repair was performed. Coronary arteries are reconstructed by Piehler's method.
  
  
  RESULTS
  There was no operative death. Valve-sparing procedure was completed without conversion to valve replacement and no significant postoperative aortic insufficiency was noted.
  
  
  CONCLUSIONS
  The excellent outcome was demonstrated with our simple modification. Although we recommend this technique of the aortic valve-sparing procedure which is reproducible and technically less demanding, close observation would be mandatory concerning with valvular durability in this particular circumstance.
authors.affiliation: Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Uchida
authors.forename: Cholsu
authors.initials: C
authors.lastname: Kim
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Miyazaki
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ohba
authors.forename: Ken
authors.initials: K
authors.lastname: Nakamura
authors.forename: Jun
authors.initials: J
authors.lastname: Hayashi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Sadahiro
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results