Combined Ravitch and Valve-Sparing Root Replacement

This video showcases a case involving a combined Ravitch procedure for severe pectus excavatum and valve-sparing root replacement, along with mitral valve repair, performed at the Bristol Children’s Hospital. 

The patient was a 15-year-old with Marfan syndrome who presented with an enlarged aortic root and mitral valve prolapse, in addition to a severe pectus excavatum deformity. Thus, the plan was to perform a combined Ravitch and cardiac surgery. 

The authors submitted this video with the intention that viewers can scroll to the parts that interest them, while maintaining full detail throughout the procedure.

The surgery commenced with the resection of the costal cartilages, followed by a sternotomy. Subsequently, Serban Stoica performed a mitral repair with CV chords to the posterior and anterior mitral leaflets through a transatrial approach. The aortic root was then resected, and a valve-sparing root replacement was conducted using a Dacron Valsalva graft. 

At the end of the operation, three Stryker straight narrow 3 mm plates were placed across the second, third, and fourth ribs and across the sternum to stabilize the chest.

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