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J Thorac Cardiovasc Surg 2002;123:33-39
© 2002 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

One-year appraisal of a new aortic root conduit with sinuses of Valsalva

From Cattedra di Cardiochirurgia, Università di Roma Tor Vergata, Rome, Italy.

Received for publication April 4, 2001. Revisions requested May 22, 2001; revisions received July 25, 2001. Accepted for publication July 26, 2001. Address for reprints: Ruggero De Paulis, MD, Cattedra di Cardiochirurgia, Università di Roma Tor Vergata, European Hospital, via Portuense 700, 00149 Roma, Italy (E-mail: depauli{at}tin.it).

Objectives: We evaluate the clinical results 1 year after an anatomic reconstruction of the aortic root in which we used a specifically designed aortic root prosthesis that incorporates the sinuses of Valsalva.
Material and Methods: The new aortic Dacron prosthesis has a proximal portion in the Dacron conduit that expands on implantation, creating pseudosinuses. During a 12-month period, 28 patients (mean age 59 ± 14 years) underwent a Bentall operation (12 cases), a remodeling procedure (7 cases), and a reimplantation procedure (9 cases) with the use of a new aortic root conduit. All patients had aortic root aneurysm with an anatomically normal (for the valve-sparing procedure) or diseased aortic valve (for the Bentall operation). Five patients had aortic dissection and 5 had Marfan disease. The mean follow-up was 6 ± 3 months. All patients underwent postoperative transesophageal and transthoracic echocardiographic studies.
Results: All patients survived and were in good clinical condition at the latest follow-up. Postoperative echocardiography showed a marked reduction in ventricular volumes in all patient groups (P < .0005). In the Bentall group the new prosthesis appeared to reduce the tension on the coronary ostial sutures. In patients undergoing both types of valve-sparing procedures a similar normal anatomy of the aortic root was reconstructed. In the reimplantation group the anulus was smaller than in the remodeling group (P = .01). Patients undergoing the reimplantation procedure had less bleeding and a lower incidence of residual valve insufficiency.
Conclusions: The new aortic root prosthesis allowed the reconstruction of the aortic root anatomy in all types of surgical techniques with low postoperative morbidity.

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