Review
The aortic root: structure, function, and surgical reconstruction
M J Underwood, G El Khoury, D Deronck, D Glineur, R Dion
Department of
Cardiovascular and Thoracic Surgery, Universite Catholique de Louvain,
Cliniques Universitaires Saint-Luc, Brussels, Belgium
Correspondence to: Mr M J Underwood, Department of Cardiac Surgery, Bristol Royal Infirmary, Bristol, BS2 8HW, UK
Accepted 17 September
1999
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Introduction |
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Aortic valve insufficiency may be caused by abnormalities of the leaflets, the root, or a combination of both. In some patients, the primary pathology is confined to the aortic root itself, the leaflets remaining anatomically normal. These patients have progressive dilatation of the aortic sinuses and, on occasion, dilatation and distortion of the annulus which results in valvar incompetence.1 Most cases are "idiopathic" (annuloaortic ectasia) but it may be associated with a wide spectrum of pathological conditions which include the Marfan syndrome,2 aortic dissection and aortitis,3 4 along with rare systemic disorders such as Ehlers-Danlos syndrome.5
Aortic root pathology has now been reported as the most common cause of
aortic valve incompetence in the United States, an observation which
probably reflects the decline of rheumatic valve disease.1
Current conventional treatment for patients with significant aortic
incompetence caused by a dilated, aneurysmal aortic root is replacement
of the ascending aorta using a
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