Deep Dive Into Aortic Surgery: Mini-Access CAVIAAR Procedure, Part 2: How to Restore Aortic Valve Competency

Aortic root remodelling with external subaortic annuloplasty (CAVIAAR procedure) enables physiological movements of the aortic cusps within three symmetrically reconstructed neosinuses, thus preserving root expansibility with the interleaflet triangles (1). In addition, the external aortic annuloplasty prevents annular base dilatation. In Part 2, the author demonstrated how to restore the aortic valve competency, by creating three symmetrical neosinuses, ensuring intercommissural equidistance, performing central cusp plication repairs, and downsizing the external subannular annuloplasty on a beating heart, ie. the Down Under Noose. 

References

1. Lansac E, Di Centa I, Vojacek J, Nijs J, Hlubocky J, Mecozzi G, Debauchez M. Valve sparing root replacement: the remodeling technique with external ring annuloplasty. Ann Cardiothorac Surg. 2013 Jan;2(1):117-23. doi: 10.3978/j.issn.2225-319X.2013.01.15. PMID: 23977568; PMCID: PMC3741820.

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