title: Proposed modification for valve-sparing aortic root replacement.
abstract: Valve-sparing aortic root replacement (ARR) is the procedure of choice in young patients with aortic root aneurysm and preserved aortic valve leaflets; however, coronary ostial anastomoses remain an issue. Troublesome bleeding sometimes occurs during surgery, and in the long term, there is a risk of aneurysmal formation in the residual aortic wall of the ostial "button." We describe a technique of valve-sparing ARR wherein each coronary button along with its flange of aortic tissue is implanted within the prosthetic graft used for ARR, thereby eliminating the risk of both immediate surgical bleeding and late coronary button aneurysms.
authors.affiliation: Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Mahesh
authors.affiliation: Clinique St. Augustin, Bordeaux, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Deville
authors.affiliation: Papworth Hospital, Cambridge, United Kingdom. Electronic address: sam.nashef@papworth.nhs.uk.
authors.forename: Samer
authors.initials: S
authors.lastname: Nashef
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D003323:Coronary Aneurysm / Q000517:prevention & control*; D054326:Coronary Sinus / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D059351:Organ Sparing Treatments / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012092:Replantation / Q000379:methods; D013536:Suture Techniques; D016896:Treatment Outcome