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Composite aortic valve-root conduit replacement has been the mainstay and a ‘gold standard’ of aortic root aneurysm surgery for the last half century. The main limitation of this procedure had been the inclusion of a prosthetic aortic valve replacement, which brings with it valve-related complications. Thirty years ago, valve-sparing aortic root replacement was developed enabling the preservation of a healthy aortic valve when treating aortic root aneurysm. Two gianst of cardiac surgery, Magdi Yacoub1 and Tirone David2 noted that an otherwise healthy aortic valve becomes incompetent in aneurysmal root, because the cusps are pulled apart by the stretched aortic wall. By bringing the commissures closer when replacing the root, the normal valve function was restored and valve replacement was evaded (figure 1). With excellent long-term results and avoidance of valve-related complication, the valve-sparing root replacement became a class I recommendation, especially in young adults.3
Footnotes
Contributors MAD is responsible for the content of this manuscript. He has conceived the idea of this editorial, drafted, edited and written the final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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