Aortic root replacement surgery is a complex surgical procedure to treat dilation or aortic enlargement (aneurysm) of a section of the large blood vessel that carries blood from your heart to your vital organs (aorta). The aortic root is located near the junction of your aorta and your heart.
Doctors perform aortic root surgery to prevent an aneurysm rupture or a tear in the inner layer of the wall of the dilated aorta (aortic dissection), and to prevent the dilated aorta from stretching the attached aortic valve.
During aortic root operations, the aortic valve may be repaired or replaced, depending on its appearance. Many aortic aneurysm surgeries can be performed with minimally invasive methods. Compared to traditional surgery, minimally invasive approaches may be associated with reduced pain, less scarring, and shorter recovery time. Most aneurysms of the aortic root can be done through skin incisions of approximately 5cm, although we never compromise a patient’s safety to achieve a cosmetic result.
Aortic root replacement surgery is a procedure to treat an enlarged section (aneurysm) of the aorta. The aorta is the large blood vessel that carries blood from the heart to the rest of the body. The aortic root is the section of the aorta closest to and attached to the heart. It represent the outflow tract from left ventricle, provides the supporting structures for the leaflets of the aortic valve, and forms the bridge between the left ventricle and the ascending aorta. The aortic valve has three flaps (or cusps) surrounded by a fibrous ring (the annulus).
An aneurysm is an abnormal bulge (>55mm) in the wall of an artery. This aneurysm happens due to the buildup of fat and cholesterol which causes the aortic wall to break down and become weak. When the aneurysm develops in the aortic root, the aorta can dilate and the aortic valve can leak (regurgitation). If the aneurysm continues to expand, it can rupture. The layers of the aortic wall can also separate (aortic dissection). This can cause life-threatening internal bleeding.
Aortic root repair or replacement surgery may be necessary:
- If you have Marfan syndrome. (An inherited disorder that affects connective tissue.)
- If you have complications from high blood pressure such as tear of the aortic wall
- To reduce the risk of stroke
- To reduce the risk of or because of endocarditis (infection of the heart)
- To treat aortic aneurysm
This aortic root replacement surgery can be performed using the following methods:
Non-invasive (no incisions required / small puncture / low to moderate sedation),
Through open-heart surgery (a large incision of 8-10 inches long / involves dividing the breast bone / general anesthesia).
The type of procedure chosen will vary according to patient diagnosis and other comorbidities.
Our surgeons perform several types of aortic root surgery, including:
- Aortic root replacement removes a section of the aorta and the aortic valve. The section of the aorta is replaced with an artificial tube (graft), and the aortic valve is replaced with a mechanical or biological valve.
- Valve-Sparing Aortic Root Replacement (David or Yacoub): A procedure that repairs aortic root aneurysms while preserving the patient’s own aortic valve. Preservation of your own existing valve avoids the need for long-term use of blood-thinning medications and increases the long-term durability of the valve.
- Composite Aortic Root Replacement (Modified Bentall): A type of procedure performed to repair the aortic root and replace the damaged aortic valve with a prosthetic or synthetic valve made of artificial material which is sewn into the base of a synthetic graft.
- Homograft Valve or Root Replacement: This surgery is done for complex cases (endocarditis or multiple previous root surgeries), this procedure may use a tissue graft from a donated human heart.