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Aortic valve sparing operations
  1. RUGGERO DE PAULIS,
  2. GIOVANNI MARIA DE MATTEIS,
  3. LUIGI CHIARIELLO

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A new aortic Dacron prosthesis (Sulzer Vascutek, Renfrewshire, UK) that replaces the aortic root and at the same time recreates the sinuses of Valsalva has been designed (top; LV, left ventricle). It has been employed in the two types of surgical techniques more commonly used to spare the aortic valve: the reimplantation (or David I) technique where the natural valve is sutured inside the Dacron conduit, and the remodelling (or Yacoub) technique where the Dacron conduit is tailored to fit the crescent shape of the aortic root.

A transoesophageal echocardiographic long axis view of the aortic root during diastole in a patient after a Yacoub type of valve sparing procedure (middle; Ao, prosthetic ascending aorta) and during systole in a patient after a David I type of valve sparing procedure using the new Dacron conduit (bottom) shows the normal shape and dimension of the sinuses, the natural narrowing of the sinotubular junction, and the perfect alignment of the open leaflet with the prosthetic ascending aortic wall.

Upon implantation of the new aortic root conduit and without technical modification of the techniques as originally described by their authors, it is possible to restore a perfect anatomy of the aortic root.

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