What is an Aortic Root Repair?

Reviewed By: Pramod Kerkar, MD, FFARCSI

Aortic root constitutes the first portion of any thoracic aorta, which is responsible for joining the outflow from the left part of the ventricle i.e. main heart pump towards the remaining segments present in the aorta.

What is an Aortic Root Repair?

Surgeries to deal with Aortic Root Aneurysms. Until now, surgeons have used the following major aortic root repair surgical methods to cure the aortic root aneurysms patients.

Auxiliary Cannulation for Aortic Root Repair

Axiliary Cannulation surgical method allows surgeons to preserve the natural blood flow via the body and the brain by simply redirecting the blood coming from aorta via an artery that remains present beneath the clavicle. Here, doctors use an axillary graft for connecting the patient with the respective heart-lung machine.

Before the opening of an aortic arch, innominate artery clamps to reduce the flow of blood from the respective machine. However, cold bloods perfuse the brain consistently during the complete procedure related to the reconstruction of the arch. The addition protection level allows any surgeon to perform various complicated reconstructions without any risk or danger related to stroke or neurologic factors related to the embolism.

Valve Sparing Type of Aortic Root Replacement

Valve Sparing type of Aortic Root Replacement is one of the specialized surgical procedures, in which surgeons repair a specific portion of the aorta that remains close to the patient’s heart or the aortic root, while simultaneously, preserving his/her aortic valve. Certain patients develop problems affecting the aortic root.

Valve sparing surgery becomes very much essential to cure the enlarged aortic root or its aneurysm. Surgeons thus remove the enlarged section and replace them with the synthetic tube referred as graft.

During the surgical procedure, doctors keep the aortic valve of a patient aside and use it again. Initially, surgeons remove the valve across the aorta’s dilated section. Later on, surgeons preserve the aortic valve of patients, use special sews and stitches to sew it within the synthetic graft, while simultaneously, reattach the patients’ coronary arteries.

Freestyle Aortic Root Replacement

Freestyle type of aortic root replacement is one of the specialized surgical procedures that aim at the replacement of the aortic root i.e. the part of the aorta that remains close to the patient’s heart and the aortic valve by performing a single operation. This operation becomes very much essential whenever both aortic valve and aortic root come in diseased condition. Aortic root enlarges or suffers from aneurysm.

Aortic valve may be of too stiff and narrow or may contain birth defect. Surgeons remove the complete aortic root and replace it by using a freestyle and prosthetic aortic valve. This is a biological valve obtained from the pig’s heart. In case of any additional section present in the enlarged aorta, doctors remove or replace it by using a synthetic tube or a graft. Graft consists of a medical graded cloth referred as Dacron used primarily for repairing or replacement of blood vessels.

Freestyle type of aortic root replacement plays a major role to correct both aortic valve disease and aortic root enlargement in a single operation. This surgery suits perfectly for all active patients with the strong desire to avoid any long-term usage of blood thinners.

Homograft Root Replacement

Homograft aortic root replacement surgery involves the removal of both aortic valve and aorta, while simultaneously, the attachment of various coronary arteries. After this, surgeons reconstruct the aortic root by the help of homograft or cadaveric human aorta. Here, the application of a human replacement valve plays a significant role to eliminate the requirement of any anticoagulation and provides superior level of blood circulation and provide long-term freedom from reoperation.