The Aortic Root: Natural History After Root-Sparing Ascending Replacement in Nonsyndromic Aneurysmal Patients

Abstract

In nonsyndromic patients, the aortic root is the slowest growing portion of the thoracic aorta. Leaving the native root, as in root-sparing ascending aortic replacement, is a safe approach regarding secondary root intervention for aortic root diameters of 45 mm or less.

The aortic root does not dilate over time after replacement of the aortic valve and ascending aorta in patients with bicuspid or tricuspid aortic valves

“…Our findings of a negligible growth rate of the aortic root in patients with BAV are supported by other recent studies with comparable observations. 24,25 Considering the mean age of the patients in this study, neither patients with BAV nor TAV are likely to require surgical intervention for aortic root aneurysm after AVR and RAA. Overall, these data support the current surgical strategy and indicate that patients might not need prophylactic replacement of a nonaneurysmal aortic root.…”

Aortic valve disease with ascending aortic aneurysm: Impact of concomitant root-sparing (supracoronary) aortic replacement in nonsyndromic patients

“…We calculated (on the basis of a comparable mean root diameter as in the present study) and according to our institutional criteria (root replacement at 50 mm) that subsequent aortic root replacement would not be required for 29 years or more. 23 The most recent findings of Vendramin and coworkers 15 clinically support these data.…”

Surgical repair of the moderately dilated ascending aorta combined with bicuspid aortic valve replacement

“…Аналогичные результаты получены S. Peterss и соавт. [35]: в отдаленные сроки (медиана наблюдения 71,9 месяца; от 13,9 до 143,8 месяца) после протезирования ВА по поводу несемейной несиндромной аневризмы ВА с сохранением зоны синусов Вальсальвы средняя скорость расширения корня аорты составила 0,41 (от 0,27 до 0,51) мм/год. В нашем исследовании скорость расширения ВА не зависела от ее исходных параметров, возраста, пола пациента, особенностей исходных нарушений кровотока на аортальном клапане, а также характеристик функционирования протеза аортального клапана в ближайшем и отдаленном послеоперационном периодах.…”